Transcript
Jonas Eddy (00:00) hey, Sandra. Okay.
Connor Morley (00:23) Hello? Good morning. Everyone. Good.
Jonas Eddy (00:25) Morning. Okay.
Connor Morley (00:30) Jonas, just to clarify for any new admins who need access to the medallion platform, just shoot us a heads up. So, if they need credentialing access or access to that credentialing model, we have to grant them an additional permission.
Jonas Eddy (00:49) Oh… okay. So if I know what you’re talking about, I sent you an email about the credentialing at bsnnet. Com account, needing the credentialing menu?
Connor Morley (01:06) Yep. I granted them that permission awesome.
Jonas Eddy (01:09) I got it. Now, I understand it was just like we were all wait a minute. What’s going on and poor Sandra who’s responsible for all of this is going medallion sucks.
Connor Morley (01:20) Oh, no, no, I granted.
Jonas Eddy (01:24) Oh, I got it. Okay. I understand why it sucks because, you know, the most important, I can’t figure anything out. Yeah. Okay. Great. That’s good. I actually meant to ask Sandra that this morning. So I’m glad that’s all been sorted out very good. Yep.
Connor Morley (01:39) Yep. It’s just a weird piece where we have to grant them like an additional user access, got it.
Jonas Eddy (01:46) Just so that’s good. I mean, it’s yeah, good to have various layers and whatnot.
Rosy Cozad (01:52) and Sandra’s the only one that needs it, Jonas.
Jonas Eddy (01:58) She’s the most important one that needs it. I have it. I don’t know really that anybody else does, I didn’t check in with it or anything like that? I don’t think they need it. It’s not a necessary thing for them. So, it’s just her and I, so far, yeah, you.
Rosy Cozad (02:17) may want to think about possibly compliance just for added third party coverage.
Elise Vall (02:22) Sure.
Jonas Eddy (02:24) Elise, do you have access to the medallion?
Elise Vall (02:29) Sorry, I was having some audio issues. I didn’t hear the first half, but yeah, I have a login for medallion and I’m getting the updates on the emails for the provider statuses and all that.
Jonas Eddy (02:39) Okay. Just check and see that you have the credentialing menu over on the left hand side and make sure that you’ve got access to that.
Elise Vall (02:47) Okay. I’ll check in now when we log in.
Jonas Eddy (02:49) Okay.
Rosy Cozad (02:51) And if not, let’s get her access, Jonas, please?
Jonas Eddy (02:54) Yes, certainly. Okay. So, Ray, I guess we could talk about this. I was actually expecting Hector to be here but if he’s not that’s okay. We can talk about this, but we did clarify on our end that somehow it was not set up for us to send you the, our credentialing contact information, and we obviously want to do that. That should be primary, you know? So Nico… I don’t know if there’s something that you need to do on your end for us to be able to do that through the API, but we definitely want to have it happen. You know, Hector would have been able to say a little bit more about that, but.
Rosy Cozad (03:45) I dropped him a note to see if he was going to join. Okay, great. And.
Connor Morley (03:52) Ray, I know that we were talking about that a little bit in the slack channel. I think we just need to figure out how to get that contact.
Rae Tompkins (04:00) Yeah, we can configure it. I can work to make sure that that’s fixed. I think the question was Jonas that you had flagged is if your contact that you provide doesn’t give us an answer, if we would reach out to the caqh imported contact, I think if you provide us a contact directly, we’ll make our three attempts and then the file will be archived as no response, but I don’t think we would reach out to the contact that you provided in addition to a caqh imported contact, we.
Niko Byron (04:31) Could do both, but we couldn’t do like one or the other. We would just be reaching out to both at the same time, I think.
Rae Tompkins (04:37) Both at the same time. Okay?
Rosy Cozad (04:38) Yeah. And Hector’s.
Jonas Eddy (04:39) about to join. Sorry?
Rosy Cozad (04:42) Hector’s about to join Jonas?
Jonas Eddy (04:43) Okay, great. Yeah, you know, in terms of your process and your end, you know, all contacts are worth calling. Certainly, we would want to make sure that our contact is in there because they’re already aware about the credentialing process going on. So they ought to be picking up the calls or responding to the emails. So obviously, we want that, the issue is that we want to make sure that we correct, is that it is in the API because right now, it appears that it isn’t what?
Niko Byron (05:18) Is in the API being able to add a credentialing contact?
Jonas Eddy (05:24) I’m sorry, say that again?
Niko Byron (05:26) Sorry, what’s missing in the API. I think I might have missed that part.
Jonas Eddy (05:30) We looked at some of the information… that we had sent to you, and in the background, we saw that our credentialing contact was not part of that information. So we need to make it part of that information. And I don’t know if that’s something that we coordinate with you or not. But Hector, maybe you have something else to say about that?
Hector A (05:58) Yeah, sorry. I’m late. Hi, Nico. Hi, everybody. Hey, how’s it going? Good, good. Yeah, Jonas was mentioning that normally, there is a process within medallion that once you don’t have all the information necessary or you, I don’t know, maybe in an instance here, you cannot validate anything something about the provider with the normal sources that you normally handle, that you have to reach out to that person or contact. And we are supposed to send you an email for that. I was looking at the API yesterday and it looks like there is a field… called credential and contact email. So we just want to make sure that is something that we can pass on. And we were, you know, we were talking about like since we don’t handle personal emails from providers, that we were going to come up with an algorithm here inside the company, that we were just going to share the information, specific organization, credential and contact with you guys through the API. And we just want to make sure that was a viable way of doing this.
Niko Byron (07:02) Yeah, definitely, that is absolutely viable. We have other customers use it. I think one thing to note is, even though in the API docs, they’re not marked as required. If you do provide credentialing contact information, you need the first name, last name and email address, you can’t just do like just the email. So you might get back like a 400 if you just sent us the email. So you don’t necessarily need to have a real first name or last name. Like, if you could just call it like this person’s credentialing contact or, you know, this person’s hospital or whatever. But like those fields are required. And then you can also put in more than one credentialing contact too. There’s another, there’s an array. If you look underneath that, it’s called additional credentialing contacts. So the first one will be the primary one I believe. And then the other ones, I’m not sure if there’s a distinction anymore actually between primary and secondary. But in the additional credentialing contacts, it’s an array of the same object where you need first name, last name and email and you could pass in, you know, five if you wanted to. But, yeah.
Jonas Eddy (08:04) Well, that just threw our business rules out the door. So we have to rewrite it.
Hector A (08:09) Yeah, no problem. But one more thing like since we already send like over 200 providers to credential, is that a way that I can give you an export of those contacts and you can put it within your system? Because I don’t think there is a way for me to kind of like send that over again and update that information? Or are we cool with those that are already inside medallion, not having that information?
Niko Byron (08:34) There might be, let me look at a flat file.
Hector A (08:38) We do have some, yeah, go ahead, sorry.
Niko Byron (08:41) No.
Hector A (08:42) Because I mean, maybe for now, maybe Jonas, we can just the ones that we already send, maybe just get a BSN email there and troubleshoot that ourselves directly in the meantime until we get the other part going or we can always do an export and give you an mpi contact file. If you’re able to update that information on your site. Well?
Jonas Eddy (09:03) So, we paused a minute to sort this out. So we’re not sending any more right at the moment until we have it figured out. I mean, we obviously know we can send it, it’s part of the API so we can get that done, and we can send the array, which is fantastic.
Jonas Eddy (09:19) That changes our formula here. That said of the 200, it’s only actually a small number where you’ve given us a response that you need to be able to reach out to them and you don’t have a way to reach out to them. So, from that standpoint, it’s not 200 that we need to give you the email for… but if there is a way for us to kind of resend that information that we’ve already sent that’s what we would be interested in hearing now. Yeah.
Niko Byron (09:58) That’s fair. Do you know how many there were just out of curiosity?
Jonas Eddy (10:04) That needed that? No, not all fans, I can.
Hector A (10:08) Tell you how many we sent, yeah, total.
Niko Byron (10:12) No worries at all. I was just wondering. I knew it was a smaller size because I was just thinking if it’s like 20.
Hector A (10:17) Or something like.
Niko Byron (10:17) that we could just do that manually through the platform and.
Jonas Eddy (10:23) It’s probably that many. Nico, seriously. It’s not, it’s probably not even 20.
Elise Vall (10:28) Okay. The very first one that we got, I don’t know if we’ve received any more only have like four or five, I.
Jonas Eddy (10:33) Think, yeah, so.
Niko Byron (10:36) Then, yeah, I mean, if you have a way of just sending, like would it be possible to ask you guys to just send those, the ones that were affected that need that email added over absolutely in a template? Yeah, then we can get that added. Okay, fantastic.
Jonas Eddy (10:51) That’s great. Thank you. We’ll.
Niko Byron (10:53) do that. Then that’s.
Hector A (10:54) also the issue until we get the last part, then I’m comfortable that Monday we’ll be able?
Niko Byron (11:01) To send?
Hector A (11:02) New ones with that information?
Jonas Eddy (11:05) Awesome.
Jonas Eddy (11:14) I think that was it for us. Oh,
Elise Vall (11:18) sorry, did.
Jonas Eddy (11:19) You get something else?
Elise Vall (11:20) I have something? Yes. So I just wanted to check in about that language regarding the credentialing information, integrity that was going to be added to the delegated agreement. I haven’t heard anything about that. Do you guys have an update or know where we’re at with that?
Connor Morley (11:36) Yeah, our team’s looking at it, we should be able to send it back soon. I don’t see Nick on the phone.
Mary Saiz (11:47) But.
Connor Morley (11:49) Our credentialing director of operations is looking at it and she should be getting that back to you. Maybe on Monday.
Mary Saiz (11:59) Okay. Sounds good.
Sandra (12:04) I had a couple questions… for those that don’t answer and they get archived.
Sandra (12:13) Do they, is there like a report that we receive or is it just going into your system and then seeing which ones aren’t.
Mary Saiz (12:22) flagged and.
Sandra (12:23) Have an issue.
Rae Tompkins (12:26) They would be under the closed queue with the status archived and the explanation would be there. But what we can do is put into place that prior to a file being archived, we can task the admins just giving you a notification. We’ve made our three attempts on dr smith. We were unable to obtain his residency verification. We will be archiving this file and what we can do is wait for you to give us the green light whether you would like us to go ahead and archive or, you know, if you’re able to provide the documentation… we.
Mary Saiz (12:57) Would like that because that way gives us an opportunity to reach out and see maybe we have other contacts that we didn’t you know, weren’t able to send or something. Yeah. So just to be clear, if you are, we are, if it goes through archiving, and then we, you know, later on get that information when we have it, is it a resubmit with a new file being counted or you would just open up that archived file and take it from there? I.
Rae Tompkins (13:30) Would need to double check with Nick on how that counts toward consumption. But once a file has been, if you receive the documentation after the file has been archived, we would just re, request it and our platform kind of start from the very beginning with processing and then just attach them, right?
Mary Saiz (13:44) Which leads me to think that you’re going to use it as one of the files for consumption. So, yeah, we would want to know before you archive because we would want an opportunity because we do have the staff that’s used to following up and helping Andrew and ourselves, obviously our providers to get on the ball.
Mary Saiz (14:05) So yeah, we would like that notification. And I don’t know if we can establish a timeline, you know, maybe in another 30 days for us to be able to do what we need to do. And then, you know, I don’t know, let you know that we’ve not been able to, we weren’t successful and we probably will terminate that provider.
Rae Tompkins (14:26) I think I’ll need to reconfirm with our operations team to get that set up. I think we typically, once we’ve made our three outreach tasks, the admins wait five days before we archive, unless we don’t receive a response just so we can make sure the file is continuing to move through the process. But we can definitely notify you prior to archiving, if you have an additional contact or if you can, you know, point us in a different direction. But I think we typically wait five days if we don’t receive a response before we archive.
Mary Saiz (14:56) Okay. Can you let us know if that is in fact the case?
Mary Saiz (15:00) And I’m not doubting you, but can we have more than five days? In other words, maybe two weeks? You know, something, I know we have to be in compliance and this is where the rubber meets the road. This is where the problem usually occurs? Yeah.
Rae Tompkins (15:15) I think the five days is set just to make sure that we are, you know, giving the file to you as soon as possible. I’ll confirm with the ops team if there’s any wiggle room, I’m going to lead towards probably five days as our standard that we follow with other clients, but I can definitely follow up via email to confirm.
Mary Saiz (15:32) Okay. Thank you.
Hector A (15:33) I have one more question for, Nico, I was going to send you an email, but since I have you here, let me just ask you real quick. So one of the things that can you see my screen? Yeah. So we have the file here already. Yeah. So one of the things that we noticed inside medallion is that you guys had a call out when some of the checks for each of the providers had like an issue? Yeah, it was like, you know, you have like a, you know, a warning triangle when something was off. I was wondering, is there a way to get that flag via the API?
Rae Tompkins (16:14) Yeah.
Niko Byron (16:16) So, I guess, are you talking about like the file status being clean versus needs attention or the actual?
Hector A (16:22) Yes, yes, because that will, for instance, for our group, it will be great to see that from all these people that are going to take the committee. Well, this one here has some issues and they will dig into those before they get the other ones to get that out of the way. Okay? So, do.
Niko Byron (16:36) You want, I guess right now, are you curious about the overall file status? Like the overall file status indicates that like one of the verifications at least has an issue, or are you asking more about those individual verifications that have the issue?
Hector A (16:50) I mean, I can start with the first one. I think that will be, you know, if I can get the just the overall flag. Yeah, and also, you can send the documentation about the specific thing. I can work in releasing one and then releasing the other one. Yeah.
Niko Byron (17:04) You can get the overall flag straight up from the webhook. Bush. Actually, there should be in the request body. There should be a credentialing status that will be either clear or needs attention. Alternatively, you can get it from the cred file API or the cred request API as well, which you could just do gets on all of them. Should have this thing called credentialing status that have.
Rae Tompkins (17:27) That.
Niko Byron (17:27) clear or needs attention or incomplete if it’s archived in some cases, but it should be one of those, right?
Mary Saiz (17:34) Right. We’re thinking more about along the lines for credentialing committee. We were, because we present the entire file for those that are flagged with any kind of issue. Yeah, that makes sense. Once it’s ready to go. And then the other ones typically, we tend to approve in bulk, but we do need the files. So just,
Niko Byron (17:54) in case, yeah, you’ll get, yeah, that totally makes sense. And that’s how some of our other customers work as well. Where the clean files don’t even get looked at committee, they just go straight through and you’ll have the files for both. So I.
Hector A (18:06) can actually.
Jonas Eddy (18:07) Just to be clear, I can actually see ultimately we’re looking to also get the subject matter too. So whatever the issue is, if there was a way to get a response on, okay, it’s about education it’s about or?
Mary Saiz (18:25) Certification or practice whatever.
Jonas Eddy (18:27) It is, if that can come back as well. That would be ideal.
Niko Byron (18:31) Yeah. So that information is also available if you query. So this is the overall file status that Hector’s showing here. But the individual verifications… if you, which id, is it? The credentialing file id there, if you were to take that and query our API, our credentialing file API. It’s the one right above the requested date right underneath request status?
Hector A (19:00) Okay. Got it.
Niko Byron (19:02) It just says credentialing file. It should say credentialing file id honestly. But yeah, if you take that one and query our credentialing file API, it should have a breakdown of like the entire credentialing file basically. So there’s an array. It’s honestly a massive payload. So please ask any questions you have, if you have any, no worries.
Hector A (19:21) No.
Niko Byron (19:21) Worries, it’s hundreds of lines long, but if you look there’s like a verifications array and each one is a breakdown of like what the individual status of that verification is, what sources were, who actually verified it and stuff like that. Fantastic.
Hector A (19:35) Yeah, that’s great. Definitely like this clear here like you’re clarifying that this variable that’s what it means, that’s a huge step because we already have this. So we just, we’re just going to put it here on the.
Niko Byron (19:44) Columns.
Hector A (19:46) Okay, perfect. Thank you so much. That was easier than an email.
Niko Byron (19:53) Awesome. All right. I.
Sandra (19:56) Had one additional thing for providers that have given us the long caqh id number, do those have to be resubmitted through the system or am I able just to respond to the notification and say, okay, this is the correct caqh… id?
Jonas Eddy (20:17) So, just to give you an example, we had a response and an email notice saying that there was a misalignment with the information that we sent and what was found in the caqh file. And this happens not irregularly and I’m sure you’ve heard it before, but, you know, an admin puts an npi for John smith and a caqh for Jane smith on the same thing and mixes them up, you know, they’re entering it, so they enter it wrong and we send it because there’s no validation for us beforehand. So you catch it. How do we respond to that? So that we can update the information to the correct caqh id?
Rae Tompkins (21:08) Nico, correct me if I’m wrong, but you would re send that through the request. And then what I can do is if you share that name with me, I can close out their incorrect request so it doesn’t sit in your queues, but we would just have it re imported with the correct information in order to ensure the syncing goes through?
Niko Byron (21:24) Yeah, we’re actually doing some work. It’s funny you bring this up because this is an issue that just recently came up that we’re doing some work on right now in the background to like when we do detect if there’s a mismatch of caqh and npi to like archive the request and delete the original provider. So in the future, I think, and I’m not sure when this is going to go live, but I think it should be pretty soon. You could just re, request the new person and it shouldn’t affect consumption at all. It shouldn’t like charge you for two credit requests. It would just be the one actual valid one would go through. But for now, I think we might have to do a little bit of manual work which is what Ray’s referring to.
Rae Tompkins (22:04) Okay. Yeah, I’m.
Sandra (22:06) happy to do that.
Jonas Eddy (22:06) That’s great.
Rosy Cozad (22:07) So, I’m hearing it’s a two step process notifying Ray so she can take it, you know, off of the pend and also resubmitting you.
Rae Tompkins (22:16) Don’t necessarily have to notify me. You can re, import it, it’ll sync through. It’s more of just a cleanup effort just to make sure if you want it off that list just to avoid any confusion internally. I’m happy to kind of clean up the back end. That way you only have successful requests.
Rosy Cozad (22:30) Yeah. And I think we would want that Ray because we would want to keep it clean.
Jonas Eddy (22:35) Happy to do that.
Mary Saiz (22:36) Right now.
Jonas Eddy (22:38) It shouldn’t be a heavy lift anyway. I don’t think we have a ton of those.
Sandra (22:42) And just for this is more for Jonas and maybe Hector to resubmit, it will still have to go through the incentive cbo.
Jonas Eddy (22:52) Yeah, Hector, I don’t know if we’ve got like a resubmit button or something like that, but we might want to consider it.
Hector A (22:58) Yeah, not right now, but yeah, we can talk about it. Yeah, I think we’re at the point Jonas, now that you guys can start sending the committee decision because the file is already available. I think that will be the next step.
Jonas Eddy (23:15) Okay. Yeah. Let’s look at it. I.
Rae Tompkins (23:19) Did have one clarifying question in regards to the pre archive notification. I did just confirm with the team that’s something we can do. I’ll confirm the timeline of prior to archiving, how long we give the admins to respond, but I want to confirm, is there a certain set of admins that should be notified or does the BSN team have like a credentialing email that they would like to be utilized?
Mary Saiz (23:44) Let’s send it to credentialing email, and then we’ll disseminate internally as to who handles that, can’t those issues with the caqh fall into that status… so that we can then respond accordingly and not have to create something new until you guys get your stuff figured out. I don’t know if I’m explaining it, right? Ray. So we were talking about issues right? Along the way. You’re trying to reach out to the provider, you can’t get through after three attempts. We have this report, but right now we’re getting issues with caqh. It’s not letting you guys proceed. We.
Jonas Eddy (24:26) Got notices on that Mary.
Mary Saiz (24:28) Right. But we’re getting individual notices and saying the issue now. Okay, we wanted to know how to send that back the correct caqh number back. So whatever path we’re going to take for that, would it not be the same thing as clearing up that archive… pre archive status? I.
Rae Tompkins (24:50) Think they’re kind of two separate things. I think what Nico was just mentioning is that’s part of an ongoing project that our team is looking into finding a solution for. But I think right now the best effort would be to, if you notify or if you identify whenever you’re in the provider caqh import tab that a provider’s import has failed if you can re, import it, but shoot me an email. I’ll make the cleanup effort on my end to make sure that those are taken out. But I think like Nico mentioned, there are product enhancements in place to kind of alleviate that. And that’s definitely something we’ll keep you updated on. But this is more in regards to, the pre archived notification being a little bit separate than that process.
Mary Saiz (25:30) Okay. Yeah, because that’s before it even starts. Okay? Exactly. Got it. Can.
Rae Tompkins (25:36) You share that credentialing email with me just to confirm I have the right one on file.
Mary Saiz (25:41) Sandy, do you have it?
Jonas Eddy (25:43) Credentialing it’s? Sandra’s email?
Sandra (25:45) Yeah. Oh, I’m.
Mary Saiz (25:47) sorry. Okay. Yeah, I thought you were asking, I thought you wanted to see Ray, the actual email you guys sent us about the sequence issue, sorry?
Rae Tompkins (25:57) Credentialing.
Jonas Eddy (25:58) At bsnnet. Com.
Rae Tompkins (26:00) Perfect. Got it. Thank you so much.
Jonas Eddy (26:07) Okay. That’s it, Sandra. Yeah, at.
Mary Saiz (26:11) Least that’s all you mentioned the red line. Yes, I heard. Yep. Yeah, yeah, we need that guys because, you know, we’re already functioning and working with you guys without really getting all clear from our payers. Yeah.
Rae Tompkins (26:26) Absolutely. I can nudge that internally to make sure that we get it back to you.
Jonas Eddy (26:30) Thank you. Yeah. All right. I think that’s it from our team.
Rosy Cozad (26:36) All right. Sounds good. Thanks.
Jonas Eddy (26:39) Everybody. Yep. Thank you guys. Thank.
Mary Saiz (26:41) You guys have a great Friday. Bye bye.