Transcript
Connor Morley (00:00) hey, Adelie. Hey, Connor, how’s it going? It’s.
Adalee Arreola (00:06) going well. How are you?
Connor Morley (00:08) Doing good. None of these privileging… requests are… complete. It looks like we have some time. Okay? I see that they’re in, let’s talk to them about those provider enrollments. Does that sound good? Adelie?
Adalee Arreola (00:36) Yeah, that sounds good. Also. They had a question about a field in payr directory last week. That field was hidden for them. So I made it available. They wanted to show… that to them.
Connor Morley (00:54) Sounds good. All right. I’m going to let them in.
Connor Morley (01:07) I got my new medallion shirt on today. Oh, nice. Okay. Hi, Pete. Hey, Marcia. Hey, Julie. So, do we get new medallion T shirts?
Alicia Iannece (01:27) Hello?
Connor Morley (01:30) Hey… that, I don’t know. It’s not like we lack for T shirts around here. There we go. I think, are we waiting on Alicia and Jannie?
Alicia Iannece (01:46) Yep. They’re coming. They.
Adalee Arreola (01:48) Were just,
Alicia Iannece (01:49) stepped out for a minute.
Connor Morley (01:51) Okay. No problem.
Connor Morley (02:02) I think we have a couple follow ups from last week… and then some new updates on a handful of things.
Connor Morley (02:27) Hello? Hey, Alicia. Hey, Jannie. Hello. Okay. I think we just want to start off with some follow ups. Adele. I think there was a piece hidden in the payr directory and that was opened… or turned visible. Are there any other questions on that field?
Adalee Arreola (02:58) Yeah. Alicia and Marcia. I just wanted to follow up last week. We had discussed there’s a field on the rosters… that you all send basically like in payr directory and you all had asked where that would be available in the platform. So I checked and it was a field that was previously hidden, but I made it visible and optional for your team, but I can kind of share where that’s located now, just so you all are able to find that and fill that out accordingly. Just give me one moment while I share my screen. Yeah. So here it is in the provider profile under professional info. You’ll see there, is this included in payr directories so you could go in and then just check. Yes or no. Okay. And that’ll complete that part. And then I guess just to speak a little bit more to those delegated rosters. Marsha, I received your email yesterday. I’m going to make those changes to the roster sometime this week. I did see some things like dba name you all want instead of the other name. And yeah, I saw those notes and I’ll be able to make those changes sometime this week… and.
Alicia Iannece (04:27) I didn’t put the board certification information in there. I forgot to do that part. So I think I still owe you that just feedback on whether… to use board certification number versus like the board certification type.
Adalee Arreola (04:43) Okay. Yeah. Feel free to just email in that same thread and I can get that updated after you decide.
Connor Morley (05:01) Okay. All right. So, if there are any other questions, just let us know. I think the next piece we had was around provider enrollments. So I know that the ask was to use the provider practice groups and the group enrollments to kind of build that out. I think we have a little concerns that we might not have all of the data, correct?
Alicia Iannece (05:32) And.
Connor Morley (05:33) there might be some, there… might… be some discrepancies or we might be kind of loading data incorrectly. Like I think in addition, we would not have any of the, we wouldn’t have any… effective dates or revalidation dates for the provider enrollments.
Alicia Iannece (05:58) Correct. We don’t have those. Okay?
Connor Morley (06:01) Like,
Alicia Iannece (06:02) we might have some recent ones, but we don’t have the majority of them or a lot of them. Okay? Even more than the majority.
Adalee Arreola (06:10) Let me share my screen because I’m seeing some data on the data import template.
Alicia Iannece (06:16) Yes. I just, I was just in there. I made a copy because the other one had data started in it and I didn’t do that. So I made a copy. Okay? So I was able this morning to submit the non par ones and it’s just that handful that are non par.
Adalee Arreola (06:32) Okay. Yeah, I think we can work with this. We can get these imported and then, and,
Alicia Iannece (06:41) I highlighted the two columns that had been added. I didn’t have those two columns, on our original template. So I didn’t know if they’re new columns. And if you need me to fill those in, I just need more direction.
Adalee Arreola (06:54) Yeah, these are like new ones that, we have added recently. Okay? Let me just take a look at what these pairs are.
Adalee Arreola (07:10) Yeah. Okay. So I would say that all of these would just fall under direct enrollment, and then the billing status that’s if you guys don’t put anything, it just defaults to active. Okay?
Alicia Iannece (07:23) So,
Adalee Arreola (07:24) if, and.
Alicia Iannece (07:25) that’s whether we’re billing for them. Yeah. Okay. And,
Connor Morley (07:29) Rheta, just to correct, if these providers are non par, do we still want to make their billing status active? Yes.
Alicia Iannece (07:37) I would say yes because we want to be par with these providers and these payers, some of them, we haven’t had the chance to submit yet and some of them, one of them got denied, and we’re still working through that. Okay?
Connor Morley (07:59) This will be a question for you and a little PE based if we load an existing enrollment even if it’s non par, can we go back into the system and request like a new payroll enrollment? Or do we have to request revalidation to submit and get them par with the payer? No?
Rheta Larson (08:19) You should be able to request a new initial that should be fine, the intended workflow. But yeah, I’m aligned there, Alicia. And then if we, sorry.
Alicia Iannece (08:30) If we,
Rheta Larson (08:32) experience anything where we can’t then let me know, but I have not seen that to be the case. Okay?
Alicia Iannece (08:38) And a handful of them are. So if you scroll to the left, dr bull is the one that got denied by the one payer at all locations. But then the other providers are, they are par with the, all those payers, but we’re adding a location or we’re like it’s a small change of like that where we’re going to be doing a demographic update and it’s for just one location. So they are par with a different location, but they’re non par with the location that we have listed, on the spreadsheet. Yeah. Okay.
Adalee Arreola (09:10) That makes sense… for those locations where these providers are par. Are you going to be listing them on here as well? I?
Alicia Iannece (09:23) Can, if that’s helpful… is this?
Adalee Arreola (09:32) A tab that you started completing this provider enrollment logic?
Alicia Iannece (09:38) No.
Adalee Arreola (09:40) Connor, is this you? Yeah.
Connor Morley (09:43) This was me just to try and get combine the PPG, and the group enrollments. Yeah. Like, I have concerns that we’re not going to be able to get in all the information or we’re going to miss something? Yeah.
Alicia Iannece (10:08) Okay. So, what… are our next steps? Are we needing to put all of them in?
Connor Morley (10:19) I think so, just because I think if… we try to do it, we are going to either miss certain practicing groups or certain payers. And if we load it when trying to pull… out data that we’ve loaded at this scale, is going to be a massive cleanup effort.
Alicia Iannece (10:51) Okay. And obviously, you guys understand what your system is capable of and all that. So, but my only thought is if we were to… yeah, I guess I just don’t know how it gets mapped out but because I feel like I could easily, it would take time but easily multiply it out based on the provider’s practices groups tab. But maybe just using a select number of fields like the provider email the provider npi and the payer and the location like upload part of it like, well, just like putting together the spreadsheet because all of the lines of business lines, those are already all established through the group enrollments. I.
Connor Morley (11:43) Think Adalee, we can copy the line of business from the group enrollments, right? Like if we see a medicaid… we can copy the line of business from group enrollments, and use that logic that I think, I mean, Adalee, do you feel comfortable kind of pulling the line of business logic from group enrollments?
Adalee Arreola (12:07) Yeah, we could do that.
Connor Morley (12:11) I think it is the provider payer practice location piece that we, we’re… a little, we’re a little worried about.
Alicia Iannece (12:22) Okay. So, do you want me to attempt it with minimum columns? And then we can work from there and see how that goes? Okay. Yeah, I’ll do that. Yeah.
Connor Morley (12:39) Okay. The other piece because I went into the system this morning to look around at your committees. It does look like there’s a system… wide issue with committee groups right now and our team’s working on getting it fixed. Okay? But well.
Alicia Iannece (13:07) We don’t have any files ready. So we’re okay. Okay. And we.
Connor Morley (13:12) talked last week and we have everything that we need in order to get the credentialing committees put together unless Rheta, are there any other concerns or things that you wanted to discuss about that?
Rheta Larson (13:27) None from my end. Yeah, I know we have the running agenda from yesterday, so those are some of the things that I still have outstanding and wanted to chat through, but nothing on the import piece. Okay?
Connor Morley (13:44) I have seen a good amount of requests go through for the payer enrollments and be completed… over the past couple of weeks. So it looks like we are moving through them pretty.
Peter Frutiger (14:04) Well.
Connor Morley (14:06) There’s a good amount that we’re still waiting to hear back from the payers themselves that are just in payer processing, and.
Alicia Iannece (14:14) Did you guys see my email yesterday, feedback from a payer from aspyrus health plan?
Rheta Larson (14:22) I don’t know if I saw that I.
Alicia Iannece (14:24) Kind of read a, Nick. I’m not sure if I sent it to anybody else but.
Connor Morley (14:29) Yeah, Rheta. Yeah.
Rheta Larson (14:31) I see it. Okay.
Connor Morley (14:32) Yeah, Rheta. I think you responded.
Peter Frutiger (14:35) Like just before this call that?
Rheta Larson (14:38) Was for the list that you sent for the revalidations. So I received that. I’m working with the team to cross compare the list. I think there was like six or seven providers that were commented for revals, but we may have submitted as initial.
Rheta Larson (14:51) So I’ll work with the PE team there. This one for aspyrus. I have not had a chance to review it, but if you want to give me like a quick rundown, I’m happy to relay this to the PE team as well and pull any aspyrus files. Let me see how many we.
Alicia Iannece (15:09) Have, yeah, I didn’t follow up with our contact who sent it to me, but basically she received an email from aspyrus that they were.
Peter Frutiger (15:24) not happy. Yeah, a little bit frustrated. They’re receiving emails from Adalee in two weeks after they received the documents and their process is 45 days.
Rheta Larson (15:36) Gotcha. I see.
Peter Frutiger (15:38) They are feeling harassed amazingly enough. So, I guess our question, is that your normal procedure that, you know, within two weeks, you start asking for updates? Yeah.
Connor Morley (15:53) That’s typically our normal follow up time, I mean for.
Rheta Larson (15:57) individual.
Connor Morley (15:58) groups, if we can certainly tell them to wait a little longer? Yeah, I think it’s up to you. Do you want us to?
Rheta Larson (16:13) Wait.
Connor Morley (16:14) Longer or do you want us to like we’re following up on your behalf. So, how do you want us to follow up with this payr?
Peter Frutiger (16:25) Spirus is now one of our problem children, and I think they’re pretty good at the 45 day mark. I would say wait 30 days, okay? Because I think Marsha, you may know if we’re missing stuff for spirus. They’re pretty good at getting back to us, aren’t they or Julie. Yeah. Again, they’re not one of our problem children… but they’re also not high volume. So I’m not too.
Rheta Larson (16:55) Worried about that, right? Yeah.
Alicia Iannece (16:57) They’re pretty low volume too.
Alicia Iannece (16:59) Yeah. So maybe switching the follow up to 30 days. And then in the email, it also asks for them to include the original application when they request follow up, and then ew, there’s also a mention about portal access that they, I,
Rheta Larson (17:15) saw that, yeah. And,
Alicia Iannece (17:16) review whether providers are approved there versus, instead of sending an email potentially.
Rheta Larson (17:24) Okay. So a few things, I just want to cross check with you all. So aspirus in general medallion’s workflow for any payer, once an application is submitted, they kick into our follow up cadence which is every two weeks or five days if priority. So, in this case, the outreach to aspirus from what I’m hearing is too frequent. They haven’t been processing long enough in order to provide valid support updates. And y’all are requesting that we wait at the thirtieth day or the 40 fifth day before we send them. I’d.
Peter Frutiger (17:59) be okay, starting to harass them at the thirtieth day?
Rheta Larson (18:01) Thirtieth? Okay?
Peter Frutiger (18:02) Yeah, because that way, you know, that’ll keep them on their 45 day window… got.
Rheta Larson (18:10) It. Okay. The exception here is the notes in platform our team. We follow very strict kind of outlines on our workflows for follow up to those files to ensure they’re moving one. And then just to make sure y’all have visibility on them at any time. So I can’t tweak it specific to aspiris, because it follows kind of like our audit process for anyone who’s working files. So we still need to put a note there. So in this instance, it will kind of be like a shell of a note stating, you know, we’ve just submitted the application, waiting until the thirtieth day to outreach to the payer, just so y’all are aware the note will still be reflected in medallion. We just won’t outreach to the payer.
Alicia Iannece (18:54) Sounds good. And so, are you saying that you’ll outreach for all payers at 30 days instead of two weeks?
Rheta Larson (19:00) No, no, no, just for aspiris.
Alicia Iannece (19:02) Okay.
Rheta Larson (19:03) And that, and that’s not even like a guarantee like we might have some fall through the cracks where they reach out, but I’m going to try and work with the team to see what the best approach is here to coach the individuals handling those files and make sure we’re not reaching out until the thirtieth day. So, I’ll pop a note in the files that’s the first piece, second piece is they include the inclusion of the application that we submitted. So whomever’s picking up the request can like, I guess cross compare what the request is intended for. I think that’s pretty typical for some of our follow up. We should be doing that initially. So if they have not been seeing, that will be a coaching point.
Alicia Iannece (19:38) And then I noticed, I did take a look at that one. I noticed there was like an email with some of the provider’s information in it, but it wasn’t like a copy of the application and I think that’s what aspires was asking for was the application itself.
Rheta Larson (19:51) Actual PDF copy. Gotcha. Yeah, we usually outreach with like SSN provider first and last name, date of birth, et cetera. So I’ll see if we can include that piece, which should not be a problem because we have the copy, but sending things via email with that sensitive info that’s where we kind of come into an issue. So I’ll double check before I give you an affirmative there. Sure. And then the individual email access. I think most of us, most of the pairs that we utilize do allow us to create the individual access points. So I’m going to take that as well and just vet to see. Are we doing this for some, and not all, are we just using the group access or like the medallion access? But it sounds like they want us to have the individual set up their own, correct?
Alicia Iannece (20:43) Yeah. And I can’t tell, I can check with our contact Cindy. But this one talked about whether we would grant them access. So I don’t know if there might be an element to that, for this payer?
Rheta Larson (20:58) And, is this?
Marsha Coffman (21:00) Aspyrus commercial or aspyrus medicare? Did they, do we know because they’re different?
Rheta Larson (21:07) I think it’s the commercial. Okay?
Alicia Iannece (21:13) Yeah.
Connor Morley (21:13) But I think Shelley’s.
Rheta Larson (21:14) manages both of them for us. I think. Okay, yeah.
Alicia Iannece (21:17) It doesn’t specify in the email. Okay? I.
Marsha Coffman (21:21) would assume it’s commercial if they didn’t say aspyrus medicare because.
Alicia Iannece (21:25) Yeah, the ones we have are for aspyrus commercial, yeah.
Marsha Coffman (21:30) Because the aspyrus commercial, there is a portal. You can go in and then you can view everybody and then that would be a good way then you, because then you would know when everybody was approved and not approved, that… would be, that would be a way that you could see when all providers were approved?
Rheta Larson (21:56) Okay. Yeah. Let me.
Alicia Iannece (21:57) Let.
Rheta Larson (21:58) me, take that feedback as well and then give it to the team to see if they can reorganize and restructure how they’re creating those for aspyrus?
Marsha Coffman (22:11) Because that does tell when everybody was, you know, so I don’t know like their revalidation dates, you know, they would, I don’t know if, it doesn’t say specifically that, but it does tell the date that they were originally approved. So, you would have those dates on there.
Rheta Larson (22:31) So… okay. That makes sense. Yeah.
Marsha Coffman (22:38) So, that might be a good login to have for the aspyrus actually?
Rheta Larson (22:47) Okay. I have those three action items for aspyrus.
Alicia Iannece (22:50) And I.
Rheta Larson (22:52) will get back to you once we implement the change, and then what date we held the coaching with the team… but I’ll definitely let you know if we receive any feedback from the payr team as well?
Rheta Larson (23:08) Yep. Any other questions on aspyrus?
Alicia Iannece (23:15) Okay. Thanks. So, I think they were the same one. We had gotten feedback from someone else on their team a couple weeks ago too. So, I think it’s kind of all connected.
Alicia Iannece (23:39) Let’s see. I’m just looking at my list from last week.
Connor Morley (23:46) I still have the signatures on the dop forms as a follow up. Our epd team is looking into it.
Alicia Iannece (23:56) And you saw Jenny’s email yesterday, yep.
Connor Morley (23:59) Okay. Yep. I saw that from dr baker.
Alicia Iannece (24:01) Okay. Sounds good. Oh, did you want to tell them about the southwest thing today?
Alicia Iannece (24:06) Oh, yeah. Southwest health and us, obviously, we’re on separate platforms, but we have people working in both platforms for our contracted providers. It sounds like even the org admins potentially will have a toggle option between the two platforms. Is that correct? Because somebody from southwest, we got an email from southwest saying that their org admins were going to have a toggle option for the credentialing contacts for those providers.
Connor Morley (24:39) Maybe not the org admins, but I think some of the team managers because I know, okay.
Alicia Iannece (24:44) The team managers?
Connor Morley (24:45) Yeah. I spoke with them yesterday, and there was one credentialing, like team manager. I think it was Sarah wells who is working on both of your we.
Alicia Iannece (24:56) Have a couple, yep, Sarah wells, and then we have lucid health as well. Both companies work for both organizations now.
Connor Morley (25:05) Yeah, I.
Peter Frutiger (25:06) told them as of now, Connor, they have to have separate logins. Is that correct?
Connor Morley (25:10) They do, and I walked southwest health through that as well, that alias piece.
Peter Frutiger (25:17) Yeah, because they just asked me and I told lucid that no, unfortunately, right now, you have to have two logins.
Connor Morley (25:24) Yeah, it’s essentially like they have to use that. Plus, I mean, it depends who was invited to medallion first. So it could be them, it could be you essentially, it could be either there’s a plus rimc alias to log into your account or a plus southwest health alias to log into theirs. This is something that we’re trying to fix and we are trying to get essentially… just to use a single email address. And then it’ll pop up. What organization do you want to log in? And it’ll be a drop down sure to make it a lot easier so that they don’t have to use those aliases, but that is, I was told that was coming in this quarter. I need to get an update from engineering on when that will be finished? Okay?
Connor Morley (26:25) But yes, you guys are correct and gave them the right information. So… perfect. I know it’s a little, it’s a little crazy with those, the aliases but bear with us while we try to get that fixed.
Alicia Iannece (26:44) I’m sure it’s more crazy for you guys than for us. So… okay… Jenny’s working through disabling the auto renewals on the credential by proxies from yesterday, I might.
Peter Frutiger (26:58) have messed up too, but we’ll see.
Alicia Iannece (27:01) We did notice we have a few that pulled in as existing appointments, but don’t have an auto renewal. Is there an option, do we just put in a date of when to schedule then the one for if we do need to schedule, have one auto renew?
Connor Morley (27:19) For what provider?
Peter Frutiger (27:21) Well, no.
Alicia Iannece (27:22) I noticed a couple names when we were looking at it yesterday, hold on. So I’m in existing. And then if I sort by expiration, date, I think that’s what I, where I noticed it. I could see all the Nas for reappointment start. Yeah. Okay. So… like Mitch Cooper… so the first one that for me that pops up as Mitch Cooper, do you want me to share my screen? Sure?
Alicia Iannece (27:56) Okay. So Mitch… Cooper would like for him, we would have a scheduled an automatic renewal but it’s… showing as na, for him.
Connor Morley (28:11) And did you create that existing? No?
Alicia Iannece (28:15) But I think he would have been one of the later ones that we maybe like it was kind of right in the middle of the build where we were taking a few still from our old cvo and it was right when they were getting uploaded into the platform is my guess gotcha. But.
Connor Morley (28:31) Yeah. So you can go over to the right hand side. Those three action hit request reappointment?
Alicia Iannece (28:39) And then just put in the D, yep. Oh, okay. Okay. We’ll do it right now, but we can take a look at those.
Connor Morley (28:49) Yep. And… I think it automatically pulls in. It… should automatically pull in. I think that 418 date was the expiration date. Yeah, I,
Alicia Iannece (29:04) think.
Connor Morley (29:05) So, it should automatically pull that. Yeah.
Alicia Iannece (29:07) 419, it looks like, yeah.
Connor Morley (29:09) It pulls in a day before essentially. Okay, sounds good. And then it is only doing the reappointments starting to a month.
Alicia Iannece (29:20) Yeah. Well, I know we’re saying 90 days. Yeah. Is there a way for it to auto default to 90 days? Yeah.
Connor Morley (29:29) Let me take a look at that because it should auto default to 90 days nice.
Alicia Iannece (29:34) Okay.
Alicia Iannece (29:40) I think, I know this patient… I might as well do it now.
Connor Morley (29:49) Wouldn’t it. Yeah. Okay. There you go. Great. Okay. All right.
Alicia Iannece (29:56) Oh, when we were, did you get something when we went to add an existing for our credential by proxy regarding privileges for them? We do have very specific privilege forms for them. I don’t think that we supplied them to you guys because they don’t need a signature by the provider again because of our contract and we have language in the forms saying that a signature is not needed. But as far as getting them in as an existing appointment and selecting privileges, I feel like we might need to have it uploaded into the system for the sake of selecting it there. Why do you need to select privileges though? Because for, when we’re putting in it’s to show say which privileges they need. So.
Connor Morley (30:45) For a credential by proxy provider, when you’re adding in the existing enrollment, there is a form that you want us to include. It doesn’t I mean, we can make, we can add in. It doesn’t have to, for these privileging forms, we can add in an additional form and then make those fields optional or?
Alicia Iannece (31:04) Would I just remove it here? You?
Connor Morley (31:06) Can remove it as well?
Alicia Iannece (31:08) Okay. So maybe we’ll just do it that way then I don’t think we need it in there either maybe.
Rheta Larson (31:12) That’s why I messed something up.
Alicia Iannece (31:14) Yesterday, we’ll see. Okay, we’ll think through that more. I was thinking the privileges was like a hard stop that we had to select something. And so I was worried that we were going to get stuck on that with the credential by proxies, nope. And.
Connor Morley (31:27) it’s just, the only thing about this is as well, you do have to take a look when you’re adding in existing appointments if you want to automatically reschedule.
Alicia Iannece (31:39) Whether or not to automatically. Okay?
Connor Morley (31:42) Yeah, auto, reschedule those existing appointments. The one thing about those credential by proxy pieces is our team would not be able to look at it.
Rheta Larson (31:52) But it.
Connor Morley (31:53) Would be a reminder to your team, that credential by proxy enrollment?
Connor Morley (32:02) Is coming up or about to expire? Sounds good?
Alicia Iannece (32:11) Okay. Great. Thank you.
Connor Morley (32:15) All right.
Alicia Iannece (32:25) I think I don’t have anything else major and Rheta, you said we’re still waiting on some of those things from yesterday and last week, so.
Rheta Larson (32:36) Yesterday, yes, I do have an update on the peps for those three bullet points we chatted through. So, okay, the pep enrollment for tricare since y’all, don’t have the formal contract with tricare. I think it was Tenzin, Shaw and smith. I did confirm that there’s no additional contracting action required on our end or anything of that nature. So I can go ahead and just mark the in flight requests as approved just as is. And then the team will stop work on those. So, I think that would, that kind of like puts that one in… out of our bucket now unless you had any other questions for tricare there?
Alicia Iannece (33:19) Okay. So moving forward, we won’t need to submit new enrollment requests for them and we could or, we could but put them in as remc owned and then automatically approve them. Is that right? Yep. Yeah.
Rheta Larson (33:32) Since y’all, are treating that as non network providers when you’re when they have, when you have a provider, you’re trying to build those services for, right? Yeah. Okay. Yeah, that, that’s aligned, security health plan. I think there was Angela, sorg, she had the task for logins for Wisconsin, we should not need those for a new enrollment. Typically, it’s only required for revalidation. So, the team is working on marking that I don’t know if they already have. I’m checking her task now, probably.
Alicia Iannece (34:15) At the bottom or towards the bottom, it’s.
Rheta Larson (34:18) still open but we’ll close that and clear it and just let Angela know that this is not applicable. She doesn’t need to do anything. So, if you’d speak to her first, just let her know there’s no action there.
Alicia Iannece (34:27) Oh, it looks like it was assigned to us. It was assigned to org admins. Oh,
Rheta Larson (34:32) okay. Perfect. Yeah, no action on y’all’s admin and I’ll mark that. Okay. Any other questions for Angela or security health?
Alicia Iannece (34:43) I don’t think so. At this point, I know we had a number of those ones pending, but… yeah, I think so long as hers is worked through, then hopefully the rest will work themselves through too. Yeah.
Rheta Larson (34:59) I’ll check to see if there’s any open tasks for security health. And then if that’s the case, we can mark those all the same. Okay. And then lastly, for medicaid par, I know you were questioning how to determine if they’re linked to the group or not. Like what do you need to put in platform or mark in platform? So for clarity, I think we use mark Mayer and Benjamin neesom as the example. You’re trying to have mark be a billing provider, and Benjamin be enrolled as a non billing provider, correct?
Alicia Iannece (35:35) Vice versa. So, no, I’m sorry, that’s both of them, we would be billing for, but Mayer would not be linked to our group. Neesom would be linked to our group.
Rheta Larson (35:50) Okay. At least for neesom, because his fits this use case. All you need to do is put the notes in the request when inputting the request that specifies that, the provider still has to be affiliated with the group in order to be billed for the group. So, I think neesom falls.
Alicia Iannece (36:11) Under that, not for medicaid. Okay? So that’s the, that’s why the question popped up. And Marsha, correct me if I’m wrong. But so, as long as they’re in the state of Wisconsin as long as they’re listed as a biller and performer, then they can bill and perform anywhere at any location. So, our rule of thumb has been like our providers who are employed by us, who primarily work for us full time, those ones we have listed as our location as well, but otherwise, they don’t need to be linked to our location by any means. Okay? I’ll.
Rheta Larson (36:46) double check on the first piece for mark just because.
Alicia Iannece (36:52) mark is an example of one he’s not primarily our provider, but we do bill for his services when he’s here.
Rheta Larson (36:59) Okay. I think it’s fine right now just to put the notes in as detailed as possible for those requests, put it in the line requests and then just make sure the ones that are going to be billed and are employed with our emc, are affiliated with the group. And I’ll double check on mark just to be sure there’s no other like differentiator we need there for him.
Alicia Iannece (37:23) Okay, sure. But.
Rheta Larson (37:25) It sounds like for the most part, we just need the note in there for the team. So that’s how we’ll plan to move those medicaid par versus non par going forward. Okay?
Alicia Iannece (37:38) Yeah, I think we’ll add that to our notes on our end as well because we have a couple notes for medicaid that, you know, we need to think about. Are they a bill of performer before we submit a new request to you guys, right? So, I’ll add that to our notes to specify whether they should or should not be linked to remc, like whether to leave it as is or whether to make that change. And I think if we’re leaving it as is typically we’re we won’t be putting a request in or we’ll put it in as remc owned and not require any medallion work on that end.
Alicia Iannece (38:16) So, is Marcia muted? No, no. Did you have something to add? Marcia? Nope? I see the head nods, I’m very grateful for both. I’m just agreeing. Yep, yes, yep. I’m seeing those and I’m very grateful.
Rheta Larson (38:31) Perfect. So PE portion, I think we’re taking care of. I’ll just double check for the non… affiliated provider and then Alyssa polk security health plan. Wisconsin. I know that was the one that was a part of that list that you sent. The team is already working to submit the revalidation for that one. Okay? So you don’t have to input a new request. They’re just going to utilize the same line, no action from y’all’s end. And then I’ll just go through the list and then let you know if we did or did not have to take action for those. Okay? Thank you. Yep. So I think that brings our list. There’s still a few things that are outstanding that we discussed from yesterday, but I will recap what I discussed with you today for the PE portion and then just let you know if I get any other updates on some of those outstanding items like for the board certificates, the privileges… to admit kind of audit with Jen. I know she’s out of office. So as soon as she returns, we’ll probably have a larger conversation there. Okay? And then Ariel, maybe just.
Alicia Iannece (39:41) go ahead and schedule an additional call with her or maybe add her to a Tuesday call that, you know, and let us know in advance. Then we can have those ready. Yeah.
Rheta Larson (39:50) Definitely, because y’all are going to be scoping those first, correct?
Alicia Iannece (39:54) Yes, we will take a look and Jenny’s going to be out next week. So I’ll keep her updated. Okay?
Rheta Larson (40:02) I think Jen might be out of office the remainder of the week. So let me check her calendar, and then I can ask her if she can join on Tuesday for our morning sync.
Rheta Larson (40:10) Okay? But other than that, I’ll just recap what we have outstanding. So that way we have it in writing and you can refer back to that if you need to revisit what we discussed or if you start noticing like, hey, the team isn’t doing what we’ve agreed upon. We can definitely have larger conversations about that. Okay. Perfect. Anything else for me on my end?
Alicia Iannece (40:35) I don’t think so specifically… I still have board certifications in the back of my head, but that’s I think we’re still working on that one, figuring that all out too. So I don’t have any concerns for today. I.
Rheta Larson (40:51) Have it posted out to the team. I’m asking for updates there. I’m trying to explain to them that it is a concern for you all because of covid the audit with joint, the joint commission and wouldn’t pass there. So I’ll let you know.
Alicia Iannece (41:08) Yeah. I did dig into our bylaws and I don’t see an ongoing requirement but I still don’t know, that protects us as far as like if something is showing as expired and it’s not, you know, confirmed that it’s renewed timely then… how does that impact us? And so I also might reach out to some of our like contacts who have recently been through surveys too, and kind of ask if that has come up for board certification specifically to see if they’re impacted by it too. Okay?
Rheta Larson (41:44) Perfect. Yeah. If you hear anything from that side first, let us know just because I know… previously, I think we mentioned it may be a bit out of scope, but because of this potential issue with the audit, I’m trying to do research on our end as well with the team. Okay? Perfect. Great. Well, that’s all I had on my end. Connor, Adalee, is there anything else you all want to add or address that’s it? Yeah.
Alicia Iannece (42:16) I think if the dop signature gets corrected, just email us for sure because we’ve got a handful of providers we’re waiting to get in touch with to do their final signature? Yep. No problem. Awesome.
Rheta Larson (42:36) All right. Wonderful.
Alicia Iannece (42:38) Thank you, guys. Have a lovely Wednesday. Thanks, everyone bye.
Rheta Larson (42:42) Thanks.