Transcript
Connor Morley (00:00) hey Nicole.
Connor Morley (00:11) Hey, Brenda. Hey, Sheila. Good afternoon… to you guys.
Sheila Simpson (00:22) Okay. Can you hear me now? Sorry?
Connor Morley (00:25) Yep. I can hear you.
Sheila Simpson (00:28) I was talking away. Nobody can hear me. It’s all good.
Connor Morley (00:35) Okay. So, I know we want to talk about how to roll this out at this point. I know we talked about sso, Adelie’s, ready to talk with your it team to get that completed and get everyone in and get the users invited into the platform.
Connor Morley (01:04) And then remind me as well. We talked about a saved report for the intranet and I don’t… know if that’s something we can do. Still, I’m still looking into it but we might have talked with your it team on how to get that in there.
Sheila Simpson (01:23) Okay. One second here.
Sheila Simpson (01:33) I’m having technical difficulties, no.
Connor Morley (01:36) Worries.
Sheila Simpson (01:37) I’m sitting in a different office right now, so it’s a little, everything’s backwards.
Sheila Simpson (01:46) Okay. Yeah. I guess my question is like what type of I haven’t played in the reporting functionality… at all to even know what we… can obtain for the end users?
Connor Morley (02:12) Yeah. So there are a couple different reports that we can run. We have some dashboards that look at payer, enrollment, ongoing… monitoring, your privileging, just provider summaries, as a whole task summaries, and then provider onboarding, and then in the report builder itself, anything on the provider’s profile, we can run reports on anything within license requests in that or, sorry, not license requests, payer enrollment requests, we can run reports on as well. And you can pretty much pull in any information. Anything that comes out of the report builder analytics most likely will have to go back to your site via sftp.
Sheila Simpson (03:01) Okay.
Connor Morley (03:02) But,
Sheila Simpson (03:06) which we don’t currently have. Yeah, we do have that set up. No, we don’t we only have the sharepoint, I’m sorry, we don’t have that set up correct in sftp site?
Connor Morley (03:18) No, but we can set that up pretty quickly with your it staff. Okay. But it would be kind of determining what report would need to get sent and then the frequency as well.
Sheila Simpson (03:35) Yeah. Okay.
Sheila Simpson (03:45) Just make myself a note here to talk to Todd. He’s our it director.
Sheila Simpson (04:01) Okay. Ultimately, what we’re looking to know is if… I have a biller that’s wanting to look up Kevin Carr, I want to know what locations he is at and what payers. He can see. How do we get that or the other way? Like there’s multiple ways that we could do this. We could do it by location of here’s, darlington clinic, these are the providers that practice there. Here are the insurance companies of those providers and facility that can go there.
Connor Morley (04:47) So you can look, you can do a couple of different things by provider… and then we can filter by. I mean, I think what probably the best way is it sounds like you want essentially this information, right? But how do you, how would you like it grouped? Because you want the provider, the payer and then the practices?
Sheila Simpson (05:17) Yep. Let me, I’m just going to kind of give you and I show you what we currently have that they’re used to. I know that this can’t be duplicated because you guys don’t have the plans in there. But just to kind of show you what we’re used to, it might help us… get to the data that we need. So this is why we’re switching because this is an enormous spreadsheet and it is, it’s horrific to, I was going to say be prepared. We didn’t even give them a warning. Sheila. I’m sorry. Yeah, this is what we had. This is what was created because when we, when I’ll be honest when I first started, we had maybe 10 of our own providers as opposed to 144 of them now. So it worked for 10. Oh my God. But what it does is like, okay here’s, unitedhealthcare here are the plans, which is why we really like the plans listed. But then you can come across here. And essentially, if they’re in uhc, this would be the line that we know we’re going to have available. Now, Mackenzie anderson was effective to one of 23. What this spreadsheet couldn’t do is by location very easily. We did start doing. Let me find one PBL, an… eye provider like here, first health. She is in network at the hospital, Cuba city, keeler, and platteville… this is what we need to get to for the users but in medallion, so.
Connor Morley (07:12) Can I, so… I think I see what you’re looking at? Okay? And I just want to like within the within medallion like I can look up anthem, right? Okay. I can just search by anthem. And I can see all the different providers with anthem and it’s by last name. It’s organized by last name. Sure, right? Yep. I can see all the practice locations that they have… like this. The… lines of businesses, their par status, effective dates. I feel like you guys are looking for essentially like this.
Sheila Simpson (08:06) Just an abbreviated version of it. This is great for what Brenda and I do and those that truly have to dig in further?
Connor Morley (08:22) You’re thinking for our frontline staff Sheila?
Sheila Simpson (08:24) Yeah, I am. Yeah. Yep.
Connor Morley (08:26) That’s like a lot of information that they don’t.
Sheila Simpson (08:29) need. Yeah. So, I guess, is it just that we need to teach them to use the filters? So like search for payr, search for anthem, and then the filter, I think you can put in if I’m looking for dr Carr, I use him because he’s been here longer than me longer than all of us. Can I put that in a filter or is the filter filtering by blue cross? Right?
Connor Morley (08:58) So, the filter is right now filtering by blue cross? Okay? And, but,
Sheila Simpson (09:06) I can do it by provider, too, right?
Connor Morley (09:09) So, I guess, so you can like right now, if you’re on the payers tab, the primary filter is going to be blue cross. So, or the primary filter is going to be the payr. So we can scroll all the way and find Kevin Carr. If we know their last name, we can get there pretty close. But if, you know, the provider already, like I can type in Carr, go to Kevin Carr, go to his payers right here, enrollment. And then I can look at all of his payers and all of the practices. And I can filter by like par status to only include par. So I can see blue cross chorus, cigna, all… of that, all of this.
Connor Morley (10:10) So, in… their workflow, like what’s easier for them, are they primarily, they have like a question on a particular provider or is it like?
Sheila Simpson (10:21) A payr?
Connor Morley (10:22) That comes in.
Sheila Simpson (10:23) Yep. So just as an example, say, just… thinking patient access right now, somebody calls in and says, I would like to schedule a physical in Cuba city for, with dr Carr, I have blue cross insurance. They go and look currently in that huge spreadsheet. We just, we just need to teach them the other way to do it.
Connor Morley (10:55) Yeah. I think the best way to do that would be essentially go by provider and the provider information. So they would get the provider information. They would go to the payr. They would hear like here’s my insurance and then they would be able to see these are the available locations where dr Carr can see you with blue cross blue.
Sheila Simpson (11:23) Shield.
Connor Morley (11:24) okay.
Sheila Simpson (11:27) So… I know that when we were talking about payr plans, there was a place that we could put notes… yep… that could list out like do not see. I can’t even think of somebody like I.
Connor Morley (11:51) don’t know medical associates.
Sheila Simpson (11:53) Yeah.
Sheila Simpson (11:58) Obviously, I mean, we will put that in under the medical associates payr. But I mean, everybody knows we don’t take medical associates but.
Sheila Simpson (12:09) Can we change the order of these columns to default for those like per the subgroup of people? Like I want to set up a group. I don’t know how to do this when we right now, Brenda and I can see everything. We are not giving that access to everyone we want view only. And essentially, like, is there a way to limit fully what they can and can’t see so that it limits, they don’t have as many places to click? So it’s not so confusing. Is that possible for users to limit what they can see? I’m not explaining that very well, no.
Connor Morley (12:54) What you’re explaining makes sense to me. I don’t know. So the team, so the auditor, the team viewer, it just depends on like what we want to limit them on. Okay. So like… my biggest question is going to be, do you want to limit them to certain groups of providers or limit them even further to only see certain pieces on a provider profile?
Sheila Simpson (13:27) Both, we would only want to have them be able to see the southwest health, the people that I put in the southwest health team, so we can do that. Yeah, we would only want them to be able to see that, but then I’d also want to limit. They do not get to see social security or date of birth. They only need to have access to the payr information and the location information, like what we’re looking at right here.
Sheila Simpson (14:03) I guess I don’t know what other columns are in here because I didn’t look.
Connor Morley (14:07) So I can limit… their ability to see social security email, full address, date of birth and… things… like that.
Sheila Simpson (14:24) Okay. Yeah, because like what I can see right now, obviously, I can see everything but it’s going to also be very hard to train when I can see different than what they can see is there like a dummy account or do I just need to have them log in and we teach them off of their accounts? I?
Connor Morley (14:44) Think it would have to be having them log in and teaching them off. I mean, I can create a dummy account for you if you have an email and first name, last name you’d like me to use. No.
Sheila Simpson (14:58) I’ll just have them log in. It’s easier. I don’t want to have to keep track of two. I’m being completely honest here. Yeah, I think… that’ll I think what, okay, you can’t see what I’m looking at, but I think how you just showed it is what we’re going to need to be able to roll it out to them. And we might not need to have anything on the internet other than we might make a shortcut for everybody to get to medallion. And that’s where the single sign on is going to come in handy. Like they won’t even have to log into the system because it’ll just be their computer login. They’ll already be in. Okay. I’ll work with Todd on that.
Connor Morley (15:51) Yeah. So I have the ability of just declare like I can remove social security email, full permanent address, background checks, any of that information. I can remove that. Okay. Yeah, for those groups.
Sheila Simpson (16:15) Yeah. Anything that like would be considered phi for a patient. We don’t want anyone else to have access to. Okay, like I don’t want them to have an address I don’t like truly.
Connor Morley (16:29) Yep. No, that makes sense.
Sheila Simpson (16:31) Yep. We’ve got to protect them too.
Connor Morley (16:36) No, that makes sense to me. Okay?
Connor Morley (16:43) And then I just have to talk to Adelie about making sure because you, since you guys will be going through single sign on, Todd will need to know how to set that up through single sign on too for like new users.
Sheila Simpson (16:59) Okay. We can set up a meeting with Todd. I think that would be best instead of me like one of us being the middleman for that. We’ll obviously still be in the meeting but, yeah, Todd’s going to know so much more about that obviously than I can even tell them. Yeah, I just know how to use it. Yeah, that’ll be, but is the first part of it getting everybody set up with an account? And like, do we have to invite them like we do the providers since they’re just going to be end users? Like what is that process? Yeah, that.
Connor Morley (17:39) Is all worked through single sign on. So Todd would create all their accounts for them and link them to whatever their single sign on account is. Okay?
Sheila Simpson (17:53) See, I don’t know that much about it. So, okay. Yeah.
Connor Morley (17:56) So, essentially… Todd will be the like invitation… admin or the user access admin. Okay? Which or whoever is your single sign on person would be that user access admin? Okay?
Connor Morley (18:25) But we can definitely get a call together with Todd. I mean, as early as tomorrow. Let me look at his calendar at like noon. I’m.
Sheila Simpson (18:40) off tomorrow. Not that, I think I can skip that part if I need to. Yeah, you’ll be okay. It’s my Friday as well. Yeah, same… yeah, rub it in. Okay. 12 year time is 11 hour time. Sorry, I just, I always have to say it out loud because you guys are like, it’s four o’clock there, right?
Connor Morley (19:09) Yes.
Sheila Simpson (19:09) Okay. Just make sure I do it, right?
Connor Morley (19:12) That as far?
Sheila Simpson (19:14) As I can tell Todd’s calendar doesn’t have anything in it for noon, 11 o’clock our time tomorrow if we could schedule a meeting and I’ll go give him a heads up too of like, hey, I just did this, yeah. And then we can work through it with him.
Connor Morley (19:36) Okay. No problem. Let me just send that out right now. Sweet. And I don’t know if I have Todd’s email.
Sheila Simpson (19:46) It is LULLT at southwesthealth. Org.
Connor Morley (19:58) Okay. So, Nicole… I can just add you for awareness. I don’t think you’re going to need to join, but Brenda, Sheila, Nicole Adelie, Todd.
Sheila Simpson (20:13) Yep. And it’ll just be me and Todd because Brenda’s like going to be slacking on us. I’m totally kidding. I want to be with you. I’ll think about all of you guys tomorrow. How’s that sound? Yes, you won’t.
Connor Morley (20:32) Liar, but we can definitely give them team viewer access so that they only have the ability to look at the southwest health providers.
Sheila Simpson (20:40) Yep. And.
Connor Morley (20:41) they would only have read only access in addition to that. We can remove. We call it PII, provider information, but that’s another piece that we can kind of limit them on. Okay?
Sheila Simpson (20:55) Okay. And then, so I’m looking at the, sorry, I’m bouncing around here. I’m looking at the provider tab right now, can we move the, is there a way to default what those, how those columns show like in what order?
Connor Morley (21:13) There’s… not a way to move them. There’s a way to remove columns if they’re not useful.
Sheila Simpson (21:22) Okay. So, they are for Brenda and I like, we need to see everything, but they wouldn’t need to see active appointments. We only have one group. So they don’t need to have that. I still don’t understand fully what the difference is between a facility and a practice location. But, sorry?
Niccole Russell (21:44) I think I,
Connor Morley (21:46) don’t know if we can default that, but they do have the ability, they would have the ability to remove that on their side. Okay, their view and we can kind of show them how to do that. It’s really, it’s you go into medallion you, you’re on the provider’s information. We can click this and then you just kind of hide what information you don’t.
Sheila Simpson (22:13) need to see and that’s what the little eyeball is.
Connor Morley (22:14) Yep. So we can hide all this…
Connor Morley (22:26) So that they would only need to see like a handful of things. Okay?
Niccole Russell (22:31) And the difference, I’m sorry, I thought you were done.
Connor Morley (22:35) Nope, go ahead, I was.
Niccole Russell (22:36) Going to say, and the difference just so you are aware, some people do have facilities, most have practice locations with my experience personally. But the difference is like a practice location that’s a physical like site specific address where the provider delivers services. So it can be a private clinic or an office, and the location for the mpi registration for medicaid and medicare. They have to do site visits. Okay? So, a facility location is a site where services are provided that’s owned and controlled by like a larger entity, like a hospital, outpatient department, skilled, nursing facility, things like that. Okay?
Sheila Simpson (23:25) So, don’t.
Niccole Russell (23:26) know if that helps you, but that’s kind of the difference between the two.
Sheila Simpson (23:30) Yeah. So, okay. I’m making a note here, quick, one sec. So all of our satellite locations, like obviously, you know, we have one group because we are one entity, one tax id.
Connor Morley (23:48) Yeah. All.
Sheila Simpson (23:50) Of the different practice locations are also either… rhc certified or joint commission certified locations. So they all are.
Niccole Russell (24:05) Controlled by a hospital, our.
Sheila Simpson (24:07) Hospital, yes, every single one of them.
Connor Morley (24:13) Do they have their own tax id?
Sheila Simpson (24:15) No, it’s one tax id.
Connor Morley (24:21) I mean, from my experience, facilities have always had their own tax id separate from the overall group.
Sheila Simpson (24:30) Okay. We don’t.
Niccole Russell (24:34) so,
Sheila Simpson (24:34) our group of southwest health encompasses all of these locations that are facilities or they’re practice locations because services are rendered there. They’re all under the umbrella of one group, southwest health. So do we, I… want to make sure I’m not missing entering something under facilities or do we even need it at all? Because the practice locations and the facilities are one and the same.
Niccole Russell (25:04) They’re enrollment wise, they’re not one and the same. Okay. So, you would need to, I can’t answer that for you. That’s something maybe you take back to your team and ask if it’s an actual practice location or a facility? Sounds to me like it’s a practice location, but I.
Sheila Simpson (25:28) don’t know under one facility? Like can… I kind of think of? I don’t know why I’m struggling so much with this. I apologize. Can I think of the facilities the same as our group? Since we truly only have one group and everything is owned and operated by southwest health, one tax id… do?
Connor Morley (25:51) You have any locations where you would do global billing and the reimbursement will go directly to the location and not the provider or the southwest health group.
Sheila Simpson (26:04) It always goes to southwest health group.
Connor Morley (26:09) I mean, so, from my experience, everything that you’re saying to me is leaning towards, you only have practice locations and you do not have facilities?
Sheila Simpson (26:20) That’s honestly, that’s what I’m thinking as well. But I don’t want to like, I don’t want to mess up and I’ll be honest, there is nobody else I can ask like I’m it, Sheila’s.
Niccole Russell (26:32) the one.
Sheila Simpson (26:34) And if I don’t know, like… I don’t even know who I would ask the question to, hence the reason I’m asking you guys because… like when I do, obviously… I do the facility enrollments all right now, like locations, practice, location, enrollments and revalidations and all of that stuff. It’s all under one like one tax id. We have obviously part a part B and the npis that fall under each, like each location has a separate npi. But it is one tax id number. All of the payments go to southwest health for the providers and for the practice locations. So to me, that truly sounds like we don’t have facilities. We have a group and we have practice locations.
Connor Morley (27:29) That’s what it sounds like to me as well. I can like ask around if we have a better definition and how to kind of switch them up. But in terms of like facilities, do you have any physical locations that you enroll? The location not tied to a group or a provider to a payer? No, no, I don’t… think you like, I don’t think you have any facilities, but I’ll confirm that with, or, Niccole, can you confirm that with… can we, who can we confirm that with?
Niccole Russell (28:13) Well, today’s my last day so I wouldn’t have an answer until next week unless you wanted to follow up.
Connor Morley (28:22) That’s okay. I can follow up. Okay, it.
Niccole Russell (28:25) Sounds to me like you have practice locations as well, but I can’t… confirm that because I’m not within your group, if that makes sense.
Connor Morley (28:39) Niccole, can I, is, Maggie brown the best person to confirm this with?
Niccole Russell (28:46) I don’t know Maggie brown or,
Sheila Simpson (28:48) Sherika?
Connor Morley (28:50) Shumpert.
Niccole Russell (28:51) Don’t know who that is, either.
Connor Morley (28:53) Okay. He’s.
Sheila Simpson (28:56) just making up names.
Niccole Russell (29:00) Connor’s been here longer than me, so I’m not sure.
Connor Morley (29:06) I can reach out to our PE ops team to see if they have any thoughts on this, but just to confirm all of your locations do not have… they don’t have a separate tin. No, they, you do not do any sort of location only enrollment there’s, no global billing tied solely to the, to a single location or reimbursement that goes to a single location as well, right? No.
Sheila Simpson (29:44) Everything, nothing goes to the separate practice locations. Everything comes back to the hospital as… God… like, I truly, I picture it as an umbrella and you have, the umbrella is southwest health. And then you have these locations that are just protected underneath southwest health that.
Connor Morley (30:11) That’s essentially how we build out the group practice kind of relationship… facilities do not fall under the group umbrella. They’re like their own group essentially.
Sheila Simpson (30:24) Okay. At least.
Connor Morley (30:25) For every customer I’ve had that has facilities, they are outside of, the group, yeah.
Sheila Simpson (30:34) So, it would be kind of like just as an example, we have an eye center that is located in Lancaster. If they had their, if they received their own payments like so owned by us, if they received their own payments, if we had to do… I don’t know if they had to be audited by joint commission on their own. They don’t that could be considered a facility, but… they would have their own tax id and, they don’t so, like truly, I don’t think that we have facilities.
Niccole Russell (31:10) Yeah. And I uploaded like the key differences there in the notes in our notes here, in this meeting, the key differences between the two, maybe that would help in determining.
Sheila Simpson (31:26) Disability as a department?
Sheila Simpson (31:33) Provider based facility?
Sheila Simpson (31:38) Well… it kind of is… yeah.
Sheila Simpson (31:55) Let’s see. Okay. So that makes it sound more like we do have facility… locations. Oh,
Niccole Russell (32:02) here’s, a facility finder maybe?
Sheila Simpson (32:06) You could look there… I’m sorry, I just don’t know. Okay. So let’s look up.
Niccole Russell (32:15) Oh, wait, it’s California, what states are you in just?
Sheila Simpson (32:19) Wisconsin?
Connor Morley (32:20) Okay.
Niccole Russell (32:22) I’m just saw it down here. It was saying CMS facility finder tool. I don’t know why California popped up out of there, but… may not be helpful, then I thought it was just all states on here, but it says… California department of health access. So just regard that one. I guess.
Sheila Simpson (32:47) Okay. Yeah. Looking at this, okay. So, they are provider based clinics. I think that, that’s the,
Connor Morley (33:03) do the providers, but the.
Connor Morley (33:10) are they, is it provider owned? No?
Sheila Simpson (33:13) It’s southwest health owned, our providers don’t own anything. I don’t mean that meanly, they… have no control, I know, and they go between locations like dr Carr practices in platteville and Cuba city. But all of his payments come back to southwest health… facility side and professional side. So like I’m looking at the definition control, the facility is a department of the main hospital. Well, they are, they have the same financial piece. They have the same administrative team of our board, and the clinical staff is the same staffing and services, the same staff, nurses, pharmacy technicians often serve both locations. They do licensure, they are part of our 855 a and 855 B enrollments. An emergency doesn’t qualify because we don’t have an offsite emergency location. So like practice location, I have no problem with how we did that because or… maybe it’s we have facilities and we don’t have practice locations… because none of them are independent and freestanding practice location.
Sheila Simpson (34:37) I’m confused.
Sheila Simpson (34:45) Up and off campus or in a commercial zoning area district from the main hospital. Well, they all are. So maybe it truly is that we do have both. I just don’t know and that’s where I’m struggling. I guess my question is what is the harm of… entering each practice location as a facility you’ll.
Niccole Russell (35:12) be charged that you want to do? Okay… because you’ll have to do enrollments for both. So, I think this one is… an all state finder one. Let me pull my chat back up here.
Sheila Simpson (35:38) Because I guess the question that I have is when like we just put in dr garrison. He’s going to be a new hospitalist. We say… we wanted to have him pay or credentialed at all of our locations. We’re picking the practice locations, but we’re not picking a facility and those get sent off then to the insurance companies to place him at all of those locations, correct? Correct? Okay. That’s what we need to have happen including medicare and medicaid.
Connor Morley (36:22) Right. That is what would happen right now?
Sheila Simpson (36:27) Okay.
Connor Morley (36:28) So, when you go into the payers and you make a request, new payer, enrollment, hang on. Let me share my screen. When you go into the payers, you make a request, and you pick a provider, I think you said garrison.
Sheila Simpson (36:45) Yeah, I just picked him because why not? Because he’s new? Yep.
Connor Morley (36:50) Yep. So I’m just going to pick one payer really quickly, yep. Edna.
Niccole Russell (36:58) Bad choice.
Connor Morley (37:00) That’s.
Sheila Simpson (37:01) okay. Yep.
Connor Morley (37:03) So, I could also do medicare… or medicaid. Why can’t I pick medicaid?
Niccole Russell (37:14) He’s already enrolled. It looks like we.
Sheila Simpson (37:17) already, we did enter in a request for him, but we didn’t include Edna because we’re not contracted with Edna. That’s okay. Maybe why? Yeah.
Connor Morley (37:25) But essentially here, you would also pick location. So, right now, you can pick all these locations that it looks like he’s connected to in the system.
Sheila Simpson (37:36) Yep. Right. And,
Connor Morley (37:38) then all of this information, all these practice locations along with all of the operational info and everything, the ptan, everything that you have on that practice profile. Yep, that’s also sent to get dr garrison enrolled with the southwest health center group, part of Edna and those practice locations.
Sheila Simpson (38:04) Okay. Is that what you’re.
Niccole Russell (38:09) used to seeing?
Sheila Simpson (38:10) Yes. Like that’s what I am expecting that we’re going to pick what locations they’re going to practice at?
Connor Morley (38:20) So, like a facility, you don’t actually associate any providers with a facility. You would just pick a facility, and a payer at least within medallion. Okay?
Sheila Simpson (38:38) Which we would never, we wouldn’t have to. We… would never have to do that. I don’t think… because we would always well.
Sheila Simpson (38:56) So, let me back up. We have tricare right now. That is saying one of our off site practice locations is not in network… but I couldn’t enter that in until I had the facility information entered. So, is that not right?
Connor Morley (39:19) Sorry, say that one more time?
Sheila Simpson (39:21) So we have Aetna telling us that I can’t remember which one it is say, darlington, not Aetna. Tricare is telling us that Aetna. No, my God, Sheila tricare is telling us that darlington clinic is not enrolled with them, like we are expecting. So I was going to put in a request to, yep, do a new payer enrollment… for a group. It would be for our group, but one practice location?
Connor Morley (40:02) Who is it with tricare?
Connor Morley (40:08) Tricare? West? Yep.
Connor Morley (40:16) So, I can.
Sheila Simpson (40:17) Do that. It was, I think darlington.
Niccole Russell (40:24) But if the group is already enrolled, it would be a demographic update, sorry?
Connor Morley (40:29) My bad, hang on one second, single or bulk single, right? Because it’s just one single, yep. Yep.
Sheila Simpson (40:35) Okay.
Connor Morley (40:38) You said tricare?
Sheila Simpson (40:40) Tricare? Yep.
Connor Morley (40:42) Last.
Niccole Russell (40:44) Practice locations down there?
Connor Morley (40:47) Darlington clinic’s right here. What needs to be updated practice locations?
Niccole Russell (40:52) So, those are the ones that are currently existing in there?
Sheila Simpson (40:56) Yeah, but they’re telling us one isn’t yeah.
Connor Morley (41:00) So, I see darlington clinic. So just, I think what we have to do is.
Sheila Simpson (41:07) just type in there that tricare is telling us darlington isn’t and we need them to be, yeah, I don’t know.
Connor Morley (41:13) Essentially, yeah.
Sheila Simpson (41:16) Okay.
Niccole Russell (41:23) So, all of these are showing as par in the system Connor?
Sheila Simpson (41:28) Which doesn’t surprise me. Okay?
Connor Morley (41:32) I think that’s just based on the information we had. Yeah, but it sounds like we just need to clarify with tricare to include darlington and, we can submit this and then just add a note tricare saying that darlington clinic is out of network and needs to be added.
Sheila Simpson (41:49) And I, yeah, and I can submit that and I know like… we definitely found holes in what we thought like different payers and different practice locations were in network. So we’re going to have a couple of those that, yes, they might show par in the system, but we’re now finding out that they’re not… but now I know how to do it. It was, I was trying to do new payer enrollment as opposed to a demographic update. I didn’t realize what the difference was between them.
Sheila Simpson (42:32) Yeah.
Niccole Russell (42:32) So, the difference between a request and like an enrollment and a demographic update is just that a demographic just think of, you need to change something. So whether you need to add a location, take away a location, change… a name, if it’s for a provider. And then an enrollment is like from scratch. Okay? So like new, okay, makes sense… which we.
Sheila Simpson (43:03) might have one coming up, which I’m not real thrilled about anyway. And I.
Niccole Russell (43:10) will say to do just to add on to be able to do a demographic update, say you are participating somewhere. If that information is not in the system, it will not allow you to do that demographic. So you’ll have to review that, get that information into the system. Not by a request. You can actually enter that, but put that information into the system. And then you would be able to do your demographic update. So if, by chance, like something wasn’t on the import template and you found that out later?
Sheila Simpson (43:46) Yep. Yeah. And we’re working on one potentially right now, signing a contract with an entirely new insurance company that does not exist in here. When I get to that point, I’m just going to call you and say help… yep.
Sheila Simpson (44:10) Okay. That helps. So, I still definitely want to validate if we need to have facilities in there because we were getting some errors on the provider side that they needed to be connected to a facility. Well, if we don’t really have facilities, how… do we get around that? What?
Connor Morley (44:31) Errors were you getting that they need to be? Yeah.
Sheila Simpson (44:35) I knew you were going to ask that.
Niccole Russell (44:36) I haven’t seen that one. It was. I think it’s still under the reminders. Like on my account, I see Mary, gee, please link provider to practice location. Is that the, no?
Sheila Simpson (44:53) Because it was saying facility? Oh,
Niccole Russell (44:57) yeah. The update email that we keep getting.
Sheila Simpson (45:01) Yeah… you practice need… and I love the ones that say need practice info when it’s really there? Sorry?
Connor Morley (45:12) If it’s there, just, you can complete that.
Niccole Russell (45:18) Well, here’s, the thing you are going to keep receiving that notice because you actually have a facility entered into medallion. Okay. You have one? I.
Sheila Simpson (45:32) did, yes.
Niccole Russell (45:33) Yeah. So you will continue to get those communications for that facility?
Sheila Simpson (45:40) So, can I delete it? I guess I don’t want to delete it until we verify for sure that I don’t need to have them there, which truly, I really don’t think we do.
Sheila Simpson (45:57) Yeah, it.
Niccole Russell (45:57) Doesn’t sound like it, but definitely verify that, and then we can remove it if you have the capability to remove. I’m not sure that you do. I’m thinking you don’t but we do on our side.
Sheila Simpson (46:08) Yeah, I only have the ability to edit. Yeah, yeah, if.
Niccole Russell (46:13) enrollments are tied to it, we will not be able to delete it on our side.
Sheila Simpson (46:18) Okay. Which I don’t think we have done any enrollments.
Niccole Russell (46:23) No, I don’t think.
Sheila Simpson (46:24) So, and added it. Yeah, I can’t I can save and I can edit that’s. All I have. So, yeah, once we know if that needs to be there, we’re either going to delete it or I will have to add a facility for each of our practice locations, if that’s what’s determined, but it’s going to be the same paperwork for every single one of them… which again, leads me to believe that we don’t really have facilities. We just have locations. So… bye… this is.
Connor Morley (47:06) An interesting one. Did you find the facilities in the facility lookup?
Sheila Simpson (47:13) I didn’t look the second one that Nicole sent. I can do that really quick.
Niccole Russell (47:18) Yeah, I looked at the first one but I didn’t.
Sheila Simpson (47:27) finddreamin. Gov? Okay.
Sheila Simpson (47:37) Maybe we’ll do within five Miles of that zip code.
Sheila Simpson (47:50) That is for behavioral health only. I just figured that out.
Brenda Runde (47:57) General.
Sheila Simpson (47:57) Hospitals including va hospitals. There is not one in platteville, but we are.
Sheila Simpson (48:10) No, I think this is more for behavioral health is what it kind of.
Brenda Runde (48:14) Oh, okay.
Sheila Simpson (48:15) Is leading me towards? Well?
Brenda Runde (48:16) See, I didn’t even ask for behavioral health. I just asked for a facility finder for all states yep.
Connor Morley (48:22) Yep.
Sheila Simpson (48:24) I get it.
Sheila Simpson (48:30) We could enroll to be on that site, but I’m not gonna.
Sheila Simpson (48:40) Yeah, search for resources for locating treatment facilities for mental and substance use disorders in the United States and its territory. So, unfortunately, no, yeah. Next, no, just kidding.
Brenda Runde (48:56) Don’t make me, I’ll send links all day. We’ll find something. Yep.
Connor Morley (49:03) Okay. So we’ll.
Sheila Simpson (49:06) continue with that, Brenda. Did you have any other outstanding questions?
Brenda Runde (49:10) Yeah. I got a couple here. Okay. Are you ready for me? Go for it? Okay? I’ll shut up now. I think you’re fine. You’re probably gonna have to help me explain this anyway, maybe. But so with… the uw contacts like the team managers that I’ve been setting up and so forth, one of them has reached out asking and I think you probably have given us this information and I clearly do not remember, but can they have one sign on between to log in to look for southwest health? And also, I feel like we talked about this because there would be like a toggle where you can switch to the reedsburg providers that are also, or I’m yeah, the reedsburg providers as well.
Connor Morley (50:07) Yeah. So right now, that toggle does not exist.
Brenda Runde (50:11) Okay. That’s the problem. Okay? So.
Connor Morley (50:13) That I thought.
Brenda Runde (50:15) You said we could, and then, okay, no.
Connor Morley (50:18) It, so that is being worked on. Okay? I am actively… hounding our engineering team for when this can be done. Okay? It was originally scheduled for this quarter. I’m just trying to get an exact date out of them right now on when this will be done. Okay? Yeah.
Brenda Runde (50:41) Because Sarah wells had reached out asking like she doesn’t want to have two sign ons, and I was like, I was kind of under the understanding that you wouldn’t have to, but she’s like, well, when I log in, I only see southwest health providers. I, my reedsburg providers are gone, and I’m like, I don’t know, can’t answer you? So I will get back to her and let her know that is being worked on the other part of that. So that would obviously be the same for like Donna, I think no hold on who did I set up? Oh, Priscilla or… Diana when she logged in for the first time, she could only see the southwest health providers. All of her reedsburg providers were gone, and it’s that’s the same situation for her as well then, correct?
Connor Morley (51:35) Yeah. Who is this? I?
Brenda Runde (51:38) Think it was Diana testa?
Connor Morley (51:41) Is this a provider or?
Brenda Runde (51:44) Nope. She’d be a team manager, sorry.
Connor Morley (51:46) Team manager, Diana… what’s her email?
Brenda Runde (51:52) DT.
Connor Morley (51:59) DTE.
Brenda Runde (52:01) ST a, I had to look it up here.
Connor Morley (52:05) Yeah, at lucid. Yeah. So, DTEST a at lucidhealth. Com. And then, yeah. So she, when she’s in the reedsburg environment or when she’s in the southwest environment, she can only see the southwest providers. I just want to double check to see if she’s in even in reedsburg right now?
Brenda Runde (52:32) She must have been able to see them before. How.
Connor Morley (52:39) So, she’s in both with the same email and I do not know how that happened.
Brenda Runde (52:50) Oh, hey, it sounds like it might be a good idea that it’s gonna happen, right? If she has it.
Connor Morley (53:01) But she’s not seeing right now.
Brenda Runde (53:05) Yeah. I think that was her initial question. How come I can only see southwest health and not reedsburg anymore?
Connor Morley (53:20) I have to talk to engineering about this because actually, I have to go to tech support and engineering right now because I don’t know how they got through? Okay? And,
Sheila Simpson (53:31) how do we change the names of them because their name right now? Is their email for the exception of Sarah wells?
Connor Morley (53:42) Oh, how do you change their name?
Brenda Runde (53:45) Huh.
Connor Morley (53:46) They can go in and change it themselves? You also have the ability. Actually… they’re the only ones who can go in and do that. It’s essentially hang… on.
Connor Morley (54:11) T testa.
Connor Morley (54:16) I mean, I can change their name in my system… but they can also change their name. So, if you go into… they log into their profile.
Connor Morley (54:37) So, this is dtesta. So they can go to profile and they can edit their name. Can you see my screen?
Brenda Runde (54:43) Yep. Yeah, they can.
Connor Morley (54:45) Edit their name to be Diana testa.
Connor Morley (54:55) And do it that way.
Connor Morley (55:02) But… right now, that’s the only way to do that. Sorry, I am messaging… epd, our engineering team and our tech support team because I don’t know how that happened that they got in without an alias.
Brenda Runde (55:30) Okay. My next question. So we… have gundersen sleep providers as kind of, I mean, their internal medicine, with the specialty of reading sleep studies if we want to, if I, if we can pull one up to kind of explain I’m being asked if sleep medicine can be added to the, let… me get it up here. So I can explain better. So, under professional… information, under dr foster… his primary specialty is, well, they wanted to put sleep medicine there. I kind of advised her to put internal medicine as primary and then under secondary, can we add sleep medicine as an option? Because I don’t see that it is an option to pick from?
Connor Morley (56:45) Yeah, we can add that. Let me get that added perfect.
Brenda Runde (56:58) Or even I see on some of like the primary specialties, where there’s like a dash. Can we do internal medicine, dash, sleep medicine or?
Connor Morley (57:05) No. Sure. Let me double check, but I don’t see why not. Okay.
Brenda Runde (57:14) That might actually be the best route to go then they wouldn’t have that secondary specialty.
Connor Morley (57:20) Yep. Sounds good to me. Yeah, there is no sleep medicine.
Brenda Runde (57:27) None at all.
Connor Morley (57:29) Weird. Okay. Okay.
Brenda Runde (57:35) I will let them know at some point that will either be added or, well, it’ll be added regardless whether we do it the primary with a hyphen or whatever. And… while we’re on dr foster, so.
Brenda Runde (57:58) I don’t know how Dale is her name? But it’s pronounced differently. She mentioned that dr… foster’s professional… history is, I don’t really know like something with all the work history that’s listed here versus the affiliations. There’s only like three affiliations, loaded. And there’s a ton of work history loaded. She was just like, first of all, she never entered that information and she was asking where it came from and I was like, I am not, I’m not sure unless this doctor is on medallion somewhere else and it somehow auto populated. I don’t know where it came from.
Connor Morley (58:48) No, it most likely came from caqh. Okay?
Brenda Runde (58:52) Well, that brings me to my next thing then. She told me that they do not well, for gunderson. They do not have caqhs. So, obviously, dr foster must have caqh somewhere else because I tried telling her it probably pulled from the caqh and she said, well, that’s weird because we don’t have caqhs and I’m like, okay, then I don’t have an answer for you.
Sheila Simpson (59:17) He could have his own, would be my assumption. He.
Connor Morley (59:20) Must have his own. I would assume he has his own because I mean, there’s a caqh id in here. I don’t know. I can like look him up in the caqh portal. Okay?
Brenda Runde (59:37) So, that must be where all the stuff where it all came from then.
Connor Morley (59:41) Huh. Yeah, most likely, Alan foster.
Sheila Simpson (59:47) So, I don’t see that in the external accounts. Oh,
Connor Morley (59:53) no, it’s not so looking at a caqh id that would be in the data imports, where they link it, the external accounts would just be their username and password. Oh… okay. And then… I’m… looking up, dr foster… it looks like.
Connor Morley (60:32) Yeah, it looks like he does have a caqh profile.
Brenda Runde (60:38) Well, that would be why then he has his own with another facility then or whatever his.
Sheila Simpson (60:45) Own personal. Yeah, that’s how like Phil burr, Mary gee had her own, like they created their own. They can, dr tashner had his own as well.
Brenda Runde (60:58) Okay. Yeah. Okay. That makes sense.
Brenda Runde (61:11) And… that might be all I.
Brenda Runde (61:20) That… might be all I had actually.
Connor Morley (61:31) All right. Well, I’ll see you tomorrow. So, if you,
Brenda Runde (61:35) have anything else, well, not me, but.
Connor Morley (61:39) Yes, let Sheila know and she can ask.
Brenda Runde (61:43) Sounds great. Yeah.
Sheila Simpson (61:45) No, I think we’re getting there. I was just trying to understand the system better,
Connor Morley (61:58) Okay. Yeah. All right. Well, thanks, everybody. Yeah.
Sheila Simpson (62:05) Thank you. All right, have.
Brenda Runde (62:07) A good day. See you tomorrow, because I won’t see you tomorrow.
Connor Morley (62:10) Have a good day. I,
Brenda Runde (62:11) will, thank you. Thank you. I’ll be.
Sheila Simpson (62:15) The slave and see you tomorrow.
Connor Morley (62:19) All right. Bye now, bye.