Transcript
Nancy Rodriguez (00:00) okay. All right. I want to see if chendel is going to join us. Give me one second. Okay. I want to stop by his office.
Niccole Russell (00:15) Oh, there he is.
Nancy Rodriguez (00:18) Oh, he’s there? Yeah.
Niccole Russell (00:20) I just, he just joined. So, I’m admitting him now and then I guess, are we waiting on Jasmine?
Nancy Rodriguez (00:26) No, Jasmine is not going to join us, okay?
Niccole Russell (00:28) Okay.
Nancy Rodriguez (00:33) So, so chendel, you want me to share my screen or you want to share the screen? You’re muted?
Niccole Russell (00:44) I said I could share my screen. Sorry… we just had some meeting went over. Yeah.
Nancy Rodriguez (01:29) So, while we’re waiting for him to set up, I just want to go back to the two questions that I sent you. And one of them was about the… locations for carelon, because the support person told us that we needed to add them as demographics. And then you said, yes, they were, if they.
Niccole Russell (01:57) Were not originally submitted, I was just stating all of your requests that you had submitted for the lines that were, are currently in the, you can see those in the carelon, payer, but if you left lines out, yes, that would be a demographic update.
Nancy Rodriguez (02:16) Okay. But we didn’t we add all of them. We added all those, all the payers in all the facilities.
Niccole Russell (02:25) It would show on the payer line for that. Okay?
Nancy Rodriguez (02:28) Let’s let’s check. Can you go into the payer line? Let’s go?
Niccole Russell (02:34) Which report, but analytics?
Nancy Rodriguez (02:36) Going to payers on the left hand side, I.
Niccole Russell (02:40) Think, yeah, she wants to look at Caroline. So if you click on Caroline… so if you scroll over to the right where it says practice locations on the bar on the bar at the bottom. Oh, over here at the very bottom. Yeah, it’s that row, but scroll over to the right just a little bit.
Niccole Russell (03:07) Yeah. So the practice locations, it shows there, which, what was added?
Nancy Rodriguez (03:15) Okay. So they were audited. So, if.
Niccole Russell (03:20) you scroll down, it goes one. And then there are a few at the bottom that have seven, but these only have the one location. See there’s your request. So you’ve got seven practices for Nas and seven for Stephen, but then from what is it? Cosor, Alvi, up, you only have one practice added in your request?
Nancy Rodriguez (03:45) No, no, no, we’re not talking about the actual providers. We’re talking about the facilities because that’s what the email came from. The reason it says you have to add the support person. Said you have to add them as demographic. So, I want to check to see if all the facilities are in process with Caroline.
Niccole Russell (04:12) Okay. Let me see here.
Nancy Rodriguez (04:15) We’re not talking about providers because… that’s what she’s saying that we have to add them in that.
Niccole Russell (04:22) Okay. So if you go to… all right, can you scroll back up there? Because you’re in Caroline? Now scroll up and then over to the left, you should have facility box right there, the top. So, right here, click on that.
Niccole Russell (04:54) Try enrollments. I don’t know if it’s been completed yet… and then click on facility here.
Nancy Rodriguez (05:06) Because the way that you guys told us to add the facilities through the group… I think we did it through here, right? Nancy. Yeah, we did it through the group, yes.
Niccole Russell (05:17) Okay. So that’s not facility, you’re just adding the practice locations. Okay. So then go to the group. No, right here.
Niccole Russell (05:34) Okay. So… Caroline, you have two, you have two practices here that are active. Okay, let’s go to enrollment request up here at the top.
Niccole Russell (05:55) Go to group here.
Niccole Russell (06:04) And then… don’t see one but type in here Caroline?
Niccole Russell (06:27) Alright. And then I see seven practices.
Niccole Russell (06:36) Right there. So, right here… and then if you click, yeah, it’ll show you all the practices that.
Niccole Russell (06:53) And those are the practices that are with that group enrollment.
Nancy Rodriguez (06:56) Okay. So, you are in process?
Niccole Russell (07:01) Status payer processing? Yes. Okay. So.
Nancy Rodriguez (07:05) Then the payer replied back to… add something else. And then your support team doesn’t even come here to look at this and tells me that, and you saw that email that she said you got to add it as demographic I?
Niccole Russell (07:22) Would say it’s probably because maybe you said facility instead of group because you do have facilities. So that is technically two different things.
Nancy Rodriguez (07:32) All right. Because that’s there are all facilities though.
Niccole Russell (07:36) They’re practice locations, if it falls under a group.
Nancy Rodriguez (07:40) Okay. She hasn’t replied back. Okay. Yeah, if you.
Niccole Russell (07:45) Ever, if you ever are talking with the AI bot and you’re not getting a clear answer, if you type in human, you’ll get a human person connected to you as well.
Nancy Rodriguez (07:57) Oh, but you told me to go into the help?
Niccole Russell (08:02) Yeah. So the AI bot answers what it can and then sometimes a human comes, but if you’re not finding you’re getting the correct answer, you can type in human.
Nancy Rodriguez (08:11) So where do you type that? Because we only see.
Niccole Russell (08:14) Just in the body, just once you start, your request.
Nancy Rodriguez (08:19) Oh, so we have to type human. When were they going to tell us this?
Niccole Russell (08:26) Well, it states it, they said that it states it in the document… that I provided to you or in the help desk. It says it as well. So, I gave you a document for eem support, best practices. It says it at the bottom that you can request a human.
Nancy Rodriguez (08:50) Let’s concentrate on the report. Okay?
Niccole Russell (08:57) All right. So analytics we can look there first. This is going to give you turnaround times for, by payer. So you can export any of these reports.
Nancy Rodriguez (09:08) We want one report, Niccole, we want one report with all this information that I sent you.
Niccole Russell (09:13) You’re not going to get one report with all of it. No, you’ll get one report with most of it, but not all. How come? I thought you?
Nancy Rodriguez (09:21) Can make your own report you?
Niccole Russell (09:24) Can, but we don’t have turnaround time in a selection for that. So if you scroll around, I,
Nancy Rodriguez (09:30) need this report for tomorrow morning?
Niccole Russell (09:32) So scroll down just a little bit to the far right. So there are two bars here. Yeah, keep going. So you’ve got this bar and then you’ve got this bar there you go. Okay. So yeah, scrolling down just a little bit more. There you go. So these are your turnaround times. I think it’s up just a little bit. It shows you what’s been completed. So go up just a smidge… I think it’s right above this one. Yeah. So let’s see you’ve got, hang on. So, I was just looking at this earlier.
Niccole Russell (10:20) Oh, hang on, let’s see.
Niccole Russell (10:31) Okay. So it’s actually?
Niccole Russell (10:38) You’ve got completed enrollments… I think you need to come down just a little bit more.
Niccole Russell (10:53) So you’ve got this bar over here as well. Okay. So, all right right here. So for these payers, which is what’s been completed on your profile so far, this is the average request time and the average.
Niccole Russell (11:17) And then you’ve got PE, turnaround time details right down here.
Niccole Russell (11:26) And you can export any of these. So if you hit, if you hover over right here.
Nancy Rodriguez (11:33) Niccole, I have a meeting tomorrow morning… and I need to be able to run one report with the information that I sent you.
Niccole Russell (11:43) There is not one report that shows that information. I.
Nancy Rodriguez (11:45) Cannot give them six reports for them to look at. So, can we make a custom report so they can send it to us? If.
Niccole Russell (11:55) you do custom reports, you have to pay for them and that you would have to talk to the appeal manager in regard to that?
Nancy Rodriguez (12:01) Oh, I did not know that a custom report has to pay.
Niccole Russell (12:07) Yeah, because most of the information within medallion… it, you can pull it, pull a report yourself.
Niccole Russell (12:16) And then we also have these different analytic tabs that you can look at. So if you click the three ulysses dots, you can export that information. It’ll export to your email… but let’s see, and then it has like pay your calendar days right above that report there. So for medicare, the average request takes for center like healthcare, it takes 34 days for medicare, New York. It takes approximately 50 days to complete. So, right here.
Niccole Russell (12:53) It’s showing for this payer, it takes approximately 34. This one takes approximately 35. So there’s your turnaround times for what we’ve completed thus far. We don’t have anything payer wise that says specifically, this is what the turnaround time is. So that information is listed there. Let’s see.
Chendel Hooks (13:21) Niccole, I’m sorry, when it says here average request completed, what does the complete mean? Does that mean that you guys have gotten feedback like as far as approvals or?
Niccole Russell (13:30) Yeah. For the participating status, it took 34 days for center like healthcare and 25 for medicare.
Chendel Hooks (13:37) Okay. So that means we have 34 people that should be approved through center, like.
Niccole Russell (13:42) It’s 34 calendar days.
Chendel Hooks (13:45) Okay. 34, it took 34 calendar.
Niccole Russell (13:47) Days.
Chendel Hooks (13:48) Okay. So 34 calendar days to get an approval? So we don’t know how many providers do we know how many providers that is?
Niccole Russell (13:57) You would have to look at the completed enrollments to see.
Chendel Hooks (14:02) Okay. So, okay. The completed enrollments?
Nancy Rodriguez (14:06) I’m confused because according to this analytics, it says only two people have been approved. So I don’t understand how wouldn’t it be underneath that says that they were approved because it only says two of them that are completing it, that’s just medicare.
Niccole Russell (14:25) Yeah. So there’s a, if you scroll back up there too, let’s see. That is medicare.
Nancy Rodriguez (14:33) It doesn’t tell you anybody else that it should be on the list right? Underneath?
Niccole Russell (14:38) It doesn’t say the health care, it doesn’t say center like health care. So, I’m not sure where that came from as far as in the report, but it’s showing you have two medicare enrollments that were complete, and that takes approximately 25 calendar days.
Chendel Hooks (15:01) I’m.
Niccole Russell (15:02) not sure why centerlight populated, but the other payers didn’t.
Niccole Russell (15:12) typically, it only populates information on what’s in the system or it won’t provide it. So.
Nancy Rodriguez (15:17) If they, if central light enrollments were completed, wouldn’t it show you analytical on their central light in their names, right? Isn’t that what that is for it?
Niccole Russell (15:30) Would not show that’s just a pair that’s just a turnaround time. No, no, that’s a turnaround.
Nancy Rodriguez (15:39) time, but it doesn’t tell you that they were enrolled. So in reality, only two providers have been enrolled in medicare, no one else.
Niccole Russell (15:49) Right. Yeah. I mean, we have processing, but those are the only ones that have been completed.
Nancy Rodriguez (15:55) So, basically everybody else is not enrolled yet is.
Niccole Russell (15:59) In process or needs client attention, correct?
Nancy Rodriguez (16:04) So, basically the report that I sent you there’s no way that we can create a report.
Niccole Russell (16:10) We can, we can create a report.
Nancy Rodriguez (16:16) Is there a possibility that you can help us?
Niccole Russell (16:19) Nancy, yes, yes, we can create a report based on what you asked, I was going straight off turnaround time right now to show you where that information was located? Because it cannot be pulled in a report? So that’s where you find the turnaround information, you can find different payr enrollment information here. You can export any of these reports. Now, if you want to build a custom report that is free, you would go into report builder. And this is where we can pull most of the information that you requested on in this email. So what type of request we want to look at? Payr enrollment… right? All right. So you want the provider name, and now it’s going to lay out exactly how you click it. So if you want it’s up to you, usually I do provider first and mpi since you want that.
Niccole Russell (17:19) So, yeah, provider, mpi?
Niccole Russell (17:27) And you can search anything?
Nancy Rodriguez (17:29) Yes, with the specialty tool. And then.
Niccole Russell (17:32) you can search anything in this box here instead of searching instead of… having to search through the list as well.
Chendel Hooks (17:44) Yeah, I’ve had to play with this once before. So I agree the layout isn’t the best because, but,
Niccole Russell (17:53) and then once you put, once you get all of the information that you’re looking for, the only thing I wasn’t able to find in there was last follow up date, but there is a submission date. Well?
Nancy Rodriguez (18:06) That’s important… put effective day as well to see if anything is up. So, why don’t we go over the list… provide a name… mpi, name. So, you got that… specialty, you got that practice locations?
Chendel Hooks (18:31) Yes, this has been.
Nancy Rodriguez (18:35) Okay. Payers, you got payers. Yeah. Okay. You got payers. Is there such a thing as enrollment status?
Niccole Russell (18:46) Status?
Nancy Rodriguez (18:48) Okay. Status.
Nancy Rodriguez (18:55) Effective day, I saw effective day in there.
Nancy Rodriguez (19:04) Is there a submission date or requested date?
Niccole Russell (19:09) Submission date?
Chendel Hooks (19:10) It’s a submission date? Okay?
Nancy Rodriguez (19:13) When we requested it, we want to know that as well. Is there something? No, there’s no?
Chendel Hooks (19:22) Request type request date? Yeah.
Nancy Rodriguez (19:24) Request date? Okay. You,
Niccole Russell (19:29) didn’t pull that over. You just x’d out of it. There you go. Okay?
Nancy Rodriguez (19:36) They request. They… what about they have?
Nancy Rodriguez (19:48) Do you want to do the line of business? Sure. Let’s see what it comes up to. Okay. Anything… else that we will need?
Chendel Hooks (20:08) Is that everything from the list?
Nancy Rodriguez (20:12) Well, I… have last follow up date. They seem in current status. Is there such a thing as that?
Chendel Hooks (20:22) Like maybe an age or something like that? No?
Nancy Rodriguez (20:25) No, for days, no.
Niccole Russell (20:28) No, no, we don’t have that.
Nancy Rodriguez (20:31) Breakdown by payor you?
Niccole Russell (20:34) Would have to manipulate the report once you receive it? Okay, you have to filter to that payor and see what all’s there, can we?
Nancy Rodriguez (20:40) Have average around time by payor. Does it give you that it’s.
Niccole Russell (20:46) not in there, it’s not in there.
Nancy Rodriguez (20:48) Okay. No.
Niccole Russell (20:50) So, at the bottom, once you have the report that you want, you can continue to look through the items in the left. But if you scroll down?
Chendel Hooks (20:59) Yeah, that was exported here you?
Niccole Russell (21:01) Can export it or you can schedule it. So, if you want to receive it daily weekly, however you want to do that? Yeah, and you can name it enrollment, save.
Nancy Rodriguez (21:12) It, save it. Save it.
Nancy Rodriguez (21:17) And maybe?
Chendel Hooks (21:24) What do you want to call it?
Nancy Rodriguez (21:25) Just put today’s, date on it?
Chendel Hooks (21:30) Maybe like test report, yeah.
Nancy Rodriguez (21:34) Test report, the date. Okay?
Niccole Russell (21:43) Yeah, but if it’s something you want to receive on a cadence, then maybe you could do like, well, we don’t know yet. Report or something like that?
Chendel Hooks (21:52) Do you want to schedule it or you want to wait?
Nancy Rodriguez (21:55) No, let’s not schedule it because they might have other changes. Okay, save it and I want to see now. Can you export it and see why are you asking for a name again?
Chendel Hooks (22:07) Because I’m exporting them.
Niccole Russell (22:14) So, then you all will receive that in your email once the information populates?
Nancy Rodriguez (22:19) Oh, we can’t see it right now.
Niccole Russell (22:22) No, no, oh, it’ll just show a few lines at the top just showing you kind of how it’s laid out and what information you would receive in that. And then you receive like the full report in your email.
Nancy Rodriguez (22:35) Okay. But like for example, or let’s just check Camilla for Camilla. How… come the primary provider specialty is not there? And how come the application… submission date is not there?
Niccole Russell (22:55) Let’s review her profile because I would say if it’s not there, it’s not in her profile, but we can look and see.
Niccole Russell (23:06) So, let’s see… this one.
Chendel Hooks (23:14) Let me get back to it.
Chendel Hooks (23:21) I’ll just go back to, do you want to go to, do you want to go back to her build report or to her profile? Yeah?
Nancy Rodriguez (23:34) To her profile to see how come we didn’t Camilla… no, Camilla, it was Camilla… there’s, Camilla.
Nancy Rodriguez (23:52) Would it be? You got to open it?
Chendel Hooks (23:58) I wasn’t sure I was in the first one.
Chendel Hooks (24:06) And what would it be for you? Okay?
Nancy Rodriguez (24:08) Because the primary, where would that be? It should be on the overview on the personal information and.
Niccole Russell (24:15) The professional?
Nancy Rodriguez (24:24) Oh, I think it’s under, I think it’s under her basic profile, go up a little bit.
Niccole Russell (24:34) Basic is just basic information for her. Let me see primary. I.
Nancy Rodriguez (24:40) think it’s professional history. No, the second one professional info right there.
Niccole Russell (24:47) All right. Keep going down that’s primary taxonomy. Let’s see here. So it should be under professional information.
Niccole Russell (25:06) Yeah. It looks like they changed that it used to be right there underneath profession. Now, it says primary taxonomy.
Niccole Russell (25:17) So, it used to be right here and then secondary was here. Now, it says taxonomy.
Chendel Hooks (25:35) You’re looking for a special specialty? Yep. So… with that… is that indicated by this or?
Niccole Russell (25:48) No, the profession is, let’s see, hang on.
Niccole Russell (25:59) Let’s see if they moved it anywhere.
Niccole Russell (26:07) Yeah, the profession is like their degree. So, I’m not sure why it’s not showing on yours, it’s not showing on mine either, but it used to be right underneath the professional tab?
Chendel Hooks (26:22) Undergraduate not.
Niccole Russell (26:24) That one, the professional history tab, professional info tab. So let’s see if that’s.
Niccole Russell (26:54) I’ll have to ask where that is… because it used to be right there under professional info.
Niccole Russell (27:07) And I’m not seeing the specialty listed in there at all.
Chendel Hooks (27:15) Can you see the excel file or? No? I’m sorry, can you guys see the excel file or? No, no. Okay. Just going to show the report real quick.
Chendel Hooks (27:42) I’m just going to show Nancy what it looks like real quick.
Chendel Hooks (28:01) So, Nancy, this is what it looks like.
Nancy Rodriguez (28:07) Okay. Keep going to. So basically looking at this… that’s the provider start date, keep going to the right. So we requested on… 360, right? Yep. So 23 days ago, if.
Niccole Russell (28:29) there’s anything needed if it says needs client attention, and you don’t respond to, it will sit there until that’s completed.
Chendel Hooks (28:40) So,
Niccole Russell (28:40) that’s why it’s very important anytime any information is needed for enrollment that gets completed? Because if it sits there a year saying needs client attention, it will not be processed for a year.
Chendel Hooks (28:57) So, it says first submitted app, is that when you guys submitted it to the insurance? Yes?
Nancy Rodriguez (29:06) Okay. I thought they do it in two weeks?
Niccole Russell (29:13) It depends on if the information was there for them to process that application.
Nancy Rodriguez (29:27) So, basically, so.
Niccole Russell (29:28) Request a first step submitted and call on tent and call on T, you can say was 16 days for… this one? Nope. Let’s see… this column here. Yeah. So you can see request a first step submitted, 16 days, seven days, 10 days. So it just depends on when we received the information. If something was requested there.
Chendel Hooks (30:01) So, are these just, these are regular calendar days, not business days, just regular calendar days.
Niccole Russell (30:09) Yeah, that says calendar days there.
Nancy Rodriguez (30:15) Why some of them are blank?
Niccole Russell (30:28) They haven’t been submitted yet. It’s just showing what’s in your enrollment to be submitted.
Chendel Hooks (30:35) So, this should be a status right on this?
Chendel Hooks (30:44) Where’s this? We did the status, right? We did, where is the status?
Nancy Rodriguez (30:49) We did status? I remember you did status?
Chendel Hooks (30:53) There we… go. Okay. So, number seven, this says.
Chendel Hooks (31:08) Pending pre app submission?
Nancy Rodriguez (31:10) What does that mean?
Niccole Russell (31:12) You would have to look in the line in medallion. I’m sure. Pending pre app submission, probably means the app is pending with medallion, but you can confirm any status. Who is that for Jenny?
Nancy Rodriguez (31:24) Person, Tina?
Niccole Russell (31:33) Is she a new person? Ayer, Molina?
Niccole Russell (31:48) Okay. It’s on hold pending dependency. So, pending pre exclamation is pending a dependency a prerequisite?
Nancy Rodriguez (32:05) That’s because you guys don’t get the medicare application, correct? So that’s why it’s still on hold. When did we send the medicaid applications? Can you sort it?
Niccole Russell (32:18) I am going to have to drop for another call. I had another call a few minutes ago, so I’m being called into that. Oh, okay. So I’ll let you review this. This should be everything that’s on this list that’s needed. Again turnaround time, you just have to look at the analytics tab. You can pull a report so you’re not pulling up the system or you can show them the system and show where it’s located… there’s. Not much information there, just the two payers, but that’s currently what’s showing in medallion for you?
Chendel Hooks (32:51) Gotcha. All right.
Niccole Russell (32:52) Yeah. Well, let me think. I know Nancy was talking about payers really quick before I drop. If you need to see how many providers are associated with payers, you could filter the report, filter by that specific payer and see how many providers are listed there. So you just have to manipulate it to how you need to view the report. Okay? Awesome. All right.
Nancy Rodriguez (33:14) Chendel, I’m coming over to your office now.
Chendel Hooks (33:16) Okay. No problem. Thank you all.
Niccole Russell (33:18) Right. Bye.