Transcript
Jason Zednick (00:00) hey, Gina. Good morning.
Gina Myers (00:01) Morning. How are you?
Jason Zednick (00:03) I’m doing okay. How are you?
Gina Myers (00:04) I’m good.
Jason Zednick (00:11) Give everybody else a minute or two.
Jason Zednick (00:18) Do you have any weekend plans? I?
Gina Myers (00:21) Do my grandson has his first soccer practice? He’s three, oh, right. So that’s going to be fun. And then my other grandson who’s five, has a soccer game after that, and then my seven year old grandson has a baseball game after that.
Jason Zednick (00:37) Okay. So, like you’re just?
Gina Myers (00:38) Like,
Jason Zednick (00:39) sports all day. Yeah, that’s great. I’m going to a buddy’s house for games tomorrow, which will be fun. We haven’t done it in a long time. Oh, that’s fun although it starts at like nine a. M, which is a little early.
Gina Myers (00:59) Yeah, but yeah, the first soccer thing is at eight 30.
Jason Zednick (01:02) That’s early. I mean, how long can a three year old soccer practice? It?
Gina Myers (01:09) Is just till nine? Yeah.
Jason Zednick (01:12) Yeah. We, there’s a park near our house where we, sometimes, when it’s warmer, take the dog to off leash in the mornings on the weekends and there’s always a group of… like toddler soccer practice and it’s just like running around and there’s a ball like there’s not much to it. It’s always fun to watch though.
Gina Myers (01:36) Yeah. So, why I’m so interested for his is because when his older sister had her, she played soccer a couple years ago. Yeah, he was literally like a year and a half and he was always running on the field trying to get the ball.
Jason Zednick (01:51) Okay. So, we’d have.
Gina Myers (01:52) To bring him a ball. So he would play with it, and he would literally would kick that ball around.
Jason Zednick (01:58) Okay. So… it’s in the blood a little bit. Yeah. Okay. All right. That’s okay. Yeah.
Gina Myers (02:09) How he does?
Jason Zednick (02:10) You’ll have to let me know. You’ll have to let me.
Gina Myers (02:12) Know. Yeah, my son in law is worried about him getting mad when other kids try to take the ball. It’s gonna.
Jason Zednick (02:17) Happen. It’s gonna happen. Well, it’s good though. It’s it’s you know, like a competitive spirit and you just have to teach him like how to like channel that you.
Gina Myers (02:27) Know, yeah, and work as a team.
Jason Zednick (02:28) But the spirit’s there, you know, that’s the, yeah, that’s fun that’ll be a good time. How, how warm is it there now?
Gina Myers (02:38) I guess seventies, every once in a while, we’ll have a nice day in the eighties, but for the most part, it seems like it’s seventies high seventies.
Jason Zednick (02:47) That’s not too bad. That’s.
Gina Myers (02:49) not too bad. It’s nice. What about, where are you in New York or?
Jason Zednick (02:53) I’m in New York. Yeah. And it’s been like in the fifties or forties to fifties. Oh, okay. But we’ll have a day where it’ll warm up in like 60 70, but then it’ll drop back. So it’s like.
Gina Myers (03:07) What part of New York are you in?
Jason Zednick (03:11) I’m in the city. I’m in Queens.
Gina Myers (03:13) Oh, okay.
Jason Zednick (03:14) Yeah.
Gina Myers (03:15) My husband’s cousin owns some kind of wine shop there, but it’s in New York, but I don’t know exactly where, but it’s moved to a couple of years ago. She moved to like the main section. Okay? So, I don’t know, I don’t know what it’s called, though I should look it up.
Jason Zednick (03:35) Yeah. You’ll have to find out. Let me know. I’ll go buy some wine. Yeah. We… on Sunday, we’re going to go to central park. I guess there’s cherry… blossom trees that are in blossom right now and that’s like, you know, it’s like four weeks tops. So, yeah.
Gina Myers (04:04) They only bloom for four weeks.
Jason Zednick (04:07) I don’t know if it’s four weeks, but I know it’s like a small window.
Gina Myers (04:11) Oh, gosh. I never realized that, yeah.
Jason Zednick (04:18) Hey, Alicia. All right. So, hi, how’s it going? There were two of you? And now there’s.
Gina Myers (04:29) yeah, me and the meeting invite always have some type.
Jason Zednick (04:34) Of issues, I get it.
Gina Myers (04:35) We’re usually battling it out before I jump on here.
Jason Zednick (04:38) I get it. I totally should. No worries. All right. Well, let me ask, what questions do we have for today? Let me just start there. Oh, there she… is that?
Gina Myers (04:59) Crystal, I know on, that Google sheet that you sent to crystal and Kristen, could you give me access to that? Yeah, I can, and I can check on that for her and help her with it. Let.
Jason Zednick (05:13) Me do, yeah, I imagine… the crystal’s probably a little underwater.
Jason Zednick (05:59) Okay. I just shared it with you.
Gina Myers (06:02) Okay. Thank you.
Jason Zednick (06:05) And I’m gonna take Kristen off even though her email is probably done, but that’s okay.
Jason Zednick (06:16) Okay. Oh, and here’s crystal, let her in.
Gina Myers (06:32) Okay. So, the wine shop is called bright and Goble, and it’s in downtown Brooklyn.
Jason Zednick (06:41) Bright and,
Gina Myers (06:42) Goble, like her last name is Goble. G o EBEL bright and Goble, wine and spirits… and it’s off flatbush. Flatbush.
Jason Zednick (06:57) It’s flatbush. Bright and Goble. Okay. Yeah, hold on. Let me see because I do know flatbush… wow.
Gina Myers (07:14) Jason, are you a new yorker?
Jason Zednick (07:16) I am, well, well, I live in New York. I’m from Texas.
Gina Myers (07:22) Oh, okay. Okay.
Jason Zednick (07:24) So, I never quite know how to, oh, I’m around here all the time. Yeah, I never quite know how to answer that question.
Gina Myers (07:32) Oh, you live in New York right now?
Jason Zednick (07:35) Yeah. Oh.
Gina Myers (07:36) Okay. Cool. How do you like it? Well, you look like it? Yeah.
Jason Zednick (07:40) Yeah, I love New York. I’ve been here for 15 years. So, okay. What?
Gina Myers (07:44) Made you?
Jason Zednick (07:44) Move?
Gina Myers (07:45) There.
Jason Zednick (07:46) So, I went to school in Texas for theater, and I was going to pursue acting. And so, it was like, okay, New York or la, and I like, didn’t want to continue owning a car. So, I chose New York and sold my car, and that’s it, that’s why. And so I never left. I’m still here?
Gina Myers (08:08) That’s so cool. That’s nice. Yeah. So, you’ll have to go check out the right and global wine and spirits.
Jason Zednick (08:16) I will. Yeah, like I, I’m… here, not all the time, but I do get to this area. Yeah, that’s neat. Yeah. Now, I’ll be in Texas in June. Your.
Gina Myers (08:37) family’s still here?
Jason Zednick (08:38) Yeah, my family’s still there. Most of my friends, are, my high school friends are still there and we do a trip every year and sometimes it’s in different places, but this year, we’re actually going to go back to our hometown, which is very small. And we’re going to do it there. Yeah?
Gina Myers (08:56) That’s cool. Where’s your hometown?
Jason Zednick (08:59) It’s Jacksonville. So, just south of Tyler, oh,
Gina Myers (09:03) okay. So, east Texas. Yeah, nice. So, it’s going to be fun. Did we have any issues? Crystal,
Crystal Eligon (09:17) I’m still working through that list off of the report. Yeah, so far? So good. But as for completion, we’re not there yet.
Jason Zednick (09:26) That’s okay. It’s not urgent on our side. It’s only going to be urgent if there’s some request related to the practices and all that, which I don’t think there is right now, sooner’s better than later, but like, I understand, like, you probably have a lot of competing priorities. So, I understand if, you know, it takes a little bit. We.
Gina Myers (09:51) Did see that a lot of the medicaid got released from that rid review.
Jason Zednick (09:55) Oh, did they, that’s good?
Crystal Eligon (09:58) Even some updates too. I see like there was maybe three or four for the Dallas region. Those 46 35 finally got.
Jason Zednick (10:07) Pushed through. Okay?
Gina Myers (10:09) Are we still pending the demographic updates for the groups with the medicare adding a new practice location?
Crystal Eligon (10:19) That part. I didn’t get a chance to look at. I didn’t look through anything like that as yet. This week has been mainly employee onboarding.
Crystal Eligon (10:35) How is?
Jason Zednick (10:41) The backfill… process going… for Kristen’s replacement? Oh,
Gina Myers (10:52) we’re we are on the hunt. Yeah, I sent you an email last week. Did you see it asking? Did y’all, have?
Jason Zednick (10:59) Oh, yeah. I did. I did see that. I don’t know, I don’t know how many.
Gina Myers (11:05) Houston accounts. Y’all, have to be realistic of how.
Jason Zednick (11:08) Right, right. Like… I… have one other account, that I believe is out of Houston, but that just happens to be in my book. I don’t know about the rest of the organization.
Gina Myers (11:23) Okay. We’re interviewing somebody today at one that does have some experience with medallion. She said that her company she worked for at that time used symplr. Are you familiar with that?
Jason Zednick (11:36) Yeah, I know.
Gina Myers (11:37) So, she said it was symplr, and then they transferred to medallion. So she only worked with it for a little while and then moved on to something else. Okay?
Jason Zednick (11:54) Yeah. Hey, Diego. Welcome.
Jason Zednick (12:01) Anything else crystal that you had top of mind?
Crystal Eligon (12:11) Not this very moment that’s okay. I just really want to try to work through that report first… and, you know, if I do anything pop up, I definitely will make sure and email you.
Gina Myers (12:23) Okay, great. Yeah.
Jason Zednick (12:26) I did have.
Diego Basagoitia (12:27) One question. Yeah. So, I know that medallion has this credit alliance with like five payers or something like that?
Jason Zednick (12:36) Right.
Diego Basagoitia (12:37) And Gina told me that we had an optum enrollment process fairly quick like within 30 days between submission and completion. My question here is, you know, optum, I’ve been trying to get a delegation with and they’ve been dragging their feet and I know they have a bunch of problems from the fed in essence. But my question here is, how does that credit alliance that you all have with optum? Am I to expect that anytime we ask to credential somebody? It’s going to be very quick. Is one, I know we’ve done questions on the fnp versus the pmhmp, and then we were told that we had to get a new group started in order to credential the fnps as medical instead of behavioral. So I kind of want to circle back with that and get an understanding of how does credit alliance affect our payer enrollment is one… I don’t know if you have knowledge. So.
Jason Zednick (13:53) I don’t work directly with any of the credit alliance piece. I think the only effect… it would have would be sort of like third order. You wouldn’t feel it too much. Any member of the credit alliance would see the credentialing piece of their process move… a little quicker. And the… like… re, credentialing piece on their end would be more streamlined because they’re all on the same cycle. And so their providers aren’t paying, you know, like four or five times a year. It’s just all done at once. In terms of your enrollments. It’s not something that you would necessarily like as… an organization feel a big impact on your end? That’s my understanding, but again, I’m not very close to it because I don’t have any credit alliance customers.
Diego Basagoitia (15:05) Okay. Then the second part of that is, did we get to… I mean, I guess this might be a question more with Gina, but did we get to determining? Do we need to create another entity of sorts or something for these fmps?
Gina Myers (15:24) Another group enrollment that’s what it sounded like is that we’d need a group enrollment through uhc?
Diego Basagoitia (15:33) Right. And how does that work? If, can we use the same mpi tax id, same company name of psychiatry and just run them through that. And then effectively, we have two agreements with the same company, one through behavioral and one through medical. Yeah.
Gina Myers (15:52) I would think so. I know a long time ago, we started that when we had, when we… had pirinelli and dr Bernstein in the Dallas group, that wasn’t a psychiatrist, we had a uhc group. I don’t know whatever happened to that.
Diego Basagoitia (16:14) So, we may have an actual live contract somewhere we?
Gina Myers (16:17) Might I don’t know that was like 2014 or so?
Diego Basagoitia (16:23) How do, how could we explore that? Is that something we can call and ask the provider… relations department to search?
Gina Myers (16:35) Possibly because see that’s what my, I was thinking like if we had a group… could you have a group with just fmts or would they allow, the psychiatrist in that group being a psychiatrist? Or would they only let the psychiatrist enroll in a behavioral health group?
Diego Basagoitia (17:02) That I don’t know enough about any of that. I don’t know Jason. I don’t know if you or people could help there or help us.
Jason Zednick (17:14) Yeah. We’ve been trying, Amy’s been trying to get in contact with her contacts in the credentialing department, and we haven’t heard back yet. So that’s been really slow for us. But even then that would… they might not be able to speak to the contractual piece anyway.
Diego Basagoitia (17:42) Okay. So then part of what I’m hearing is we need to see if whatever… this contract is still exists is one… and if it exists, we got to bring it back to life. And you’re saying we only had it for north Texas, yeah.
Gina Myers (18:03) So, I, what I remember was for Bernstein because… he was, a psychiatrist. Yeah. So we had something set in place for him.
Diego Basagoitia (18:35) And crystal and Jason, while on a separate topic, medicare enrollments, are those processing straightforward quickly clean? No issues. Primarily, we had a whole new group of providers start this week. So, I’m more focused in on, have those all been submitted? In essence since, we started the onboarding with that video training from Molly.
Gina Myers (19:07) Yes. And.
Diego Basagoitia (19:09) I was curious if all 10 or eight providers or whatever count if they already completed their profile submitted it. And we’ve already requested the medicare enrollments for each of those. And I’m hoping Jason, you know, that being the primary for us like the, I need that turned around ASAP. This is kind of the first batch that I want to start testing the true timelines of what’s taking our onboarding group to get them their provider profile completed? How, you know, my hope is that by Wednesday, their profiles were done and by Thursday yesterday, the medicare application was submitted. So.
Gina Myers (19:54) Where are we on that part? Crystal? Because, I know you were working on getting everybody’s medallion.
Crystal Eligon (20:03) Right. I’m trying to pull it up right now. I know for sure there’s two of them that I was able to do the medicare, Darian Stevens and Chad suggins. Those are the only two that were able to do their medicare. So they’re completely done.
Gina Myers (20:21) You requested their medicare?
Crystal Eligon (20:24) Correct. Let me tell you about the other ones and that’s.
Diego Basagoitia (20:31) because they completed their profile.
Crystal Eligon (20:34) More, so they had their chq already pretty much updated and I just had to make the adjustments for them and they were able to complete everything in medallion more or less within that 24 hour time frame because we have to wait until everything is updated in chq first. And then everything has to be imported into medallion. So that process for… coster, and montes, we’re still waiting for them to get everything linked. There’s some glitches with when I’m trying to sync everything over it’s, not pulling everything. Those are the only two that I’m having a little issues with. And collins, let me pull up the notes for her. I think she’s still working on her medallion, and then Claiborne, her profile was completely blank and I reached out to her yesterday to please go ahead and start working on her profile, but she does have her invite for medallion… Humphrey, hers, she’s still working on hers as well because hers was completely expired and you can say that’s a blank one because hers was since the last time she touched it.
Diego Basagoitia (21:49) Her caqh?
Crystal Eligon (21:51) Correct. So that.
Gina Myers (21:52) Yeah.
Crystal Eligon (21:53) That really needs to be updated. But again, and Natia?
Gina Myers (21:57) Is doing the same thing? She’s updating hers.
Crystal Eligon (21:59) Correct. So, those two.
Diego Basagoitia (22:02) Okay. So that’s good feedback because that’s information I’m going to take back to Molly because the goal is to have these profiles and everything in the medicare application. So, you know, they start Monday by Friday, right? They have five days.
Gina Myers (22:19) Yeah, to get that down.
Diego Basagoitia (22:21) And then I’m hoping that come Monday, Jason’s team is taking the applications. I don’t know what you guys do fully, Jason, but submitting it Monday or Tuesday to medicare and then trying to get medicare done by the following Monday… replied back. I don’t know if medicare moves that fast or not, but that’s I’m hoping it’s a three week process, not a, you know, five week, 12 week process that’s kind of the goal.
Jason Zednick (22:52) So one thing to keep in mind, Diego is that our submission timeline assuming… the profile is complete and intake is, you know, is it ready? Yes, which I believe it will be. It’s a, it’s a 10 day SLA on submission. So it could fall anywhere in between those days and, you know, it very often can go fast, but we do internally keep that 10 day timeline.
Diego Basagoitia (23:21) Again, I am, I understand that. But like I said from a while ago, my biggest request, medicare… and medicaid by far, right? If you guys want to take an extra day, I could care less on the mcos. And the only reason I’m saying that is alici’s team can go get authorizations. Once we have medicare and medicaid numbers, I can’t conduct further business until that, and rather, we take business losses because we don’t have those numbers, which is why it’s imperative to get those two, just those two payer enrollments completed as quickly and accurately as possible. Because that way then it falls on alici’s team, to bridge the gap, right? And that’s getting the authorizations. And again, they can only do that with a medicare number and a medicaid number. They can’t do it without one or the other. Yeah. So, I get the SLA, like I said, if you could do that in three, five days, I would prefer that you could take 12 days, 13, whatever on mcos. I could care less on those because I can still get paid through authorizations, but I can’t get paid for anything until those two are done.
Jason Zednick (24:43) Yeah, I gotcha.
Diego Basagoitia (24:46) okay. So, crystal, thank you for that. I am going to bring that back to Molly because what you’re telling me, it sounds like half the class did their job. Half the class was picking flowers and grabbing petals one at a time that’s what it sounds like. So I do want to see what we’re going to do for the next class because I, for me success will be when we achieve 80 percent of them or more. And if we had, I think 10 people and you’re telling me about five did? Okay, right? We’re only at that 50 percent mark, success is 80 percent or better. And that’s only a B. Okay. Unless the grading scale has changed, that’s only a B. So that means that what we’ll do is you said you sent off two, two or three medicare applications?
Crystal Eligon (25:37) Yes two.
Diego Basagoitia (25:38) OK. Do you think you can send off any more today or now?
Crystal Eligon (25:42) I haven’t checked them today but I will go back into the medallion platforms to see if those two are complete because once they’re complete, I can go ahead and request it.
Diego Basagoitia (25:53) OK. Let me know how many you submit to medallion. OK, if you can submit, I don’t know if you can submit five. You said you’ve already done two. I don’t know if you’ll find three more today, but my hope is whatever you submit by today. I’m going to be looking very closely next week at medallion at how fast they’re processing them. Jason, that’s why I’m telling you that if it’s on your desk on your team’s desk on Monday, but they don’t touch it till the following Monday, you know, that’s yeah, that’s going to be seven days, right? But that’s going to be, you know, I won’t be a happy camper because it’s medicare. I understand the SLA, but if it’s sitting there for seven days, I’m not going to be a happy camper. I don’t care if it sits there a day or two days or whatever, right? But I don’t want it to be touched. The whole point here is trying to see how long it’s going to really take us to ramp this production line.
Diego Basagoitia (26:51) This is the true first time that I’m going to be measuring everything as we have all this set up now. Yeah. And then part of that is also once those come back right from medicare, so it’s you guys process submit, goes to medicare however long medicare takes. And then they return it with approval with our medicare number crystal. I want to see the turnaround time to medicaid quickly.
Crystal Eligon (27:21) Okay. Yes, we did an email so that’s checked daily.
Diego Basagoitia (27:24) Okay. So then I’m going to be keeping an eye on that because I want to see the turnaround to get the medicaid payer enrollment done because we need that as quickly as possible. So, the whole point here is I’m trying to measure from the date of hire to right? Or the date of start, which was Monday of this week? Can we manage to get both medicare and medicaid within 30 days altogether? That’s kind of the goal that I’m trying to see if it’s possible. I know it’s a hard ask. I’m not oblivious to it because I understand we’re dealing with providers. We’re dealing with our own processing. We’re dealing with medallion’s own processing. We’re dealing with the payer processing, right? But I’m trying to see if it is at all possible to get this done within 30 days. And all I care right now, like I said is medicare and medicaid. That again, that’s for me success if we can get to that. And then Alicia you and your team are responsible for capturing those authorizations to bridge the gap during the mco process. So.
Alici A (28:28) Keep in mind, we can only get authorizations for payers that allow out of network benefits, which a lot of them have been.
Diego Basagoitia (28:36) Refused that’s fine. We’ll deal with that. The ones that can.
Alici A (28:40) Yes, that’s our we’ll do everything we’re supposed to.
Diego Basagoitia (28:43) Right. And most of them do have out of network benefits. So I’m not, I would. And when I say most, we’re talking about 75, 70 percent of them. So my whole point is I want to try to limit losses, get our providers productive because they’re paid on productivity, how many visits they can see, right? So we have to make sure that they are, that they’re getting their paychecks. We’ve got to make sure that we are getting reimbursed. We’ve got to make sure everything’s as timely as possible. So that’s kind of all I want to work on once that’s pretty cleaned up, then we can talk about mcos, right? Mcos will be a different process, a different animal. And that’s why I wanted Jason. I asked the question about the credit alliance. I wanted to understand that more because once we do cross the medicare medicaid bridge and we’re done with that, I want to know what mcos can we process the fastest? And the ones that I’m very, you know, high in mind is, optum, united healthcare because that’s yeah percent of our business. Yeah. Okay. So I hope that all makes sense. And you understand why I’m going to be pressing it.
Jason Zednick (29:58) It does, it does. And I do, and I think that like knowing that we’re in a place where we sort of have the process in mind. I think, you know, being able to see, okay. What are the timelines? What are the actual timelines we will be able to, you know, figure out what that is, and then we can adjust where we need adjusting. Yeah, I get it. I see what you’re trying to achieve. Yeah. Okay.
Diego Basagoitia (30:28) I just want to make sure we’re all on that same page that for the time being, we’re all focusing on the onboarding provider profile, medicare medicaid that’s the goal. And then Alisa will bridge the gap between that and mcos. So we’ll that’s going to be the new goals. I know we’ve been working on a lot of other stuff, but that’s I think it’s time for us to start setting the process especially when it comes to the new providers and the expectations that we have of increasing our headcount with the provider group over the next six months. So, I want to just have that ready to go and push. And I think right now we’re at 165 if I’m not mistaken in medallion. So I just want to make sure we’re pushing. All right. That’s all I had as far as comments and questions.
Jason Zednick (31:31) All right. Anything else, anybody?
Crystal Eligon (31:35) I’m sure I’ll be emailing you this week.
Jason Zednick (31:37) Yeah, please do, please email me.
Crystal Eligon (31:39) I’m sure. And.
Jason Zednick (31:40) I’ll get back to you. Okay. Other than that, everyone have a great weekend if something comes up, let me know and we’ll speak more soon all.
Crystal Eligon (31:50) Right. Have a good weekend.
Diego Basagoitia (31:52) Thank you. Thank.
Jason Zednick (31:53) You. Bye bye.