Transcript
Shannon Costine (00:00) good morning. Good morning. Whoa. Where’s my camera hold on? Let me switch this open. There you go. So, the one thing that she, they’re all in the waiting room. I’ll let them in a minute. The one thing she’s probably really going to be mad about is they wanted one person on their account to work at one person from PE. And I was shot down like I fought it all week to try. And then I was shot down and Amanda’s the one that sent it. So, she told Peter yesterday, she’s like it’s just one problem after another and she’s not wrong. Like how do you argue that, you know?
TamraOhnesorge (00:35) Yeah. So, all right.
Shannon Costine (00:37) Does.
Vanessa Persha (00:38) she meet with Derek at all?
Shannon Costine (00:40) Amanda? No, maybe.
Vanessa Persha (00:43) We suggest it. Okay?
Shannon Costine (00:46) Yeah. All right. I’m not going to admit the fault.
Shannon Costine (00:55) Hey guys. Good morning.
Shannon Costine (01:02) Good morning. Hey, good morning. Hey, Tamara. Happy.
TamraOhnesorge (01:08) Friday.
Shannon Costine (01:08) Happy Friday. Okay, guys. I know we’ve got quite a few issues to go over today.
Shannon Costine (01:16) So I will just start at the top which is with your question, Amanda about having one person working the account. They did not approve me for that or H ii for that. But what they did say was we could have less people working the account and having them doing the follow up as well as the submission. So currently, we have two different people doing follow up different people doing submission. What’s your thoughts on that? I believe.
Amanda Streeter (01:50) It was humana that raised the concern. Is that correct?
Shannon Costine (01:55) Yes. And is your answer? Yes, it was humana?
Amanda Streeter (01:58) Okay. Thank you, Lindsay for confirming. That is your answer with respect to just humana. We can’t assign one person or all H ii enrollments? We can’t assign one person.
Shannon Costine (02:13) All H ii enrollments. Were you wanting it just for humana?
Amanda Streeter (02:17) Well, I mean, I would love it for all H ii. I agree. Yeah, at a minimum, I mean, if a payor rep is reaching out, it’s not a good look for us or for you. So, can we have one person just handling our humana enrollments?
Shannon Costine (02:31) Yeah. Let me find out. Obviously, I can’t say yes or no, either way. So let me make a note on that… and see. I feel like that’s a reasonable ask and I.
Amanda Streeter (02:43) think it’s reasonable in the context of, I don’t think you guys want humana reps knowing your name in a negative light. Either. We certainly don’t but it’s more impactful almost for you with all of your other clients if you’re on their radar in a negative manner. So I would hope that we can get back on track with them at least on our account.
Shannon Costine (03:04) Absolutely. I will find out today and let you know on that issue. Amanda. Okay. Thank you.
Amanda Streeter (03:10) Of.
Shannon Costine (03:10) course. Okay. Next issue I had was our differences in optum and united and I did get that breakdown from Colleen. So I have added that to multiple places to your project plan. Sent it to the reps. Sent it to the leads. If you continue to see issues, please let me know again, they are very aware of who’s only optum who’s united, who’s both. So at this point forward, we should not see that… any questions on that. No. Okay. Next thing is Tamara on Janet Bryant on sunshine health?
Shannon Costine (04:02) Your question was you don’t understand why this is on hold pending dependencies. So they said the team has flagged this. They’ll determine if providers truly need to pen the group or if it can be submitted while the group is processing. He said we do have other provider enrollments processing. I have asked them to unflag that for pending dependencies. There’s no reason why it should be on hold. Do you not have, you don’t have other enrollments pending on that Tamara?
TamraOhnesorge (04:33) On that location or that provider?
Shannon Costine (04:36) On that location… Vanessa, correct me if I’m wrong, if anything’s pending on the location that’s why he’s saying we can’t push anything through. Is that right? Or is it say that?
Vanessa Persha (04:53) For me, again, is this a group enrollment? Sorry, I was trying to look at their assigned account specialist, to the payers?
TamraOhnesorge (05:01) Yeah, it’s individual and it’s hold pending group enrollment. But the location that she’s enrolled with is enrolled. They’re active with the payers. I don’t know why she has.
Shannon Costine (05:13) A dependency there shouldn’t.
Vanessa Persha (05:16) be a dependency. They need to look at the locations. So even though like let’s say that there may be a group enrollment in process like a demographic update or something like that. If it has nothing to do with the address where the provider is being linked, that group enrollment should not be a dependency for the individual enrollment.
Shannon Costine (05:39) I’m putting another follow up on that one to make sure that they release… it. I agree. Okay?
TamraOhnesorge (05:51) While we’re on that subject of things in a demographic update, I know we’ve discussed previously that if there’s a demographic update in process, we can’t submit anything else while that’s pending. We’re adding new groups and new locations all the time. And if we have to wait for that to process, that could be 60 days from now before we even get these in the wind. So there has to be a better workaround for us to be able to submit when.
Shannon Costine (06:25) something else is in process. Vanessa, I know we were talking to Sammy and them about that. Do you know if we ever landed on anything? If not, I’ll need to take that back to them.
Vanessa Persha (06:38) I don’t think that we, so there was no way we could like bypass it. There was no workaround for that. I think our next step here is to take that back to epd as product feedback and say, even if they’re not willing to look at it in terms of like a global update specific to H ii, like they need to be able to submit demographic updates while others are in process.
Vanessa Persha (07:09) They’re just going to really need to consider like all of the rules and the logic behind our platform and how that could impact anything. So, I want to say that if they agree to do this, it’s not going to be a quick fix. There’ll. Be a lot of kind of stuff in the background that they’ll have to consider. But we can give that as product feedback and see if they’re willing to put that on the roadmap?
TamraOhnesorge (07:34) I’m surprised to hear this.
Amanda Streeter (07:36) Isn’t something that’s coming up with other providers like if you were waiting to get credentialed… and had to hold billing and there was a methodology for getting credentialed sooner like it’s just really surprising to me that we’re the first people asking for this.
Vanessa Persha (07:57) You know, I did have a customer prior that asked for the same thing, but they were asking for like 100 things. So I think that one fell lower on the priority list when epd was working through things. And so they may already have it on their roadmap. But they may have only scoped it specific to that customer so we can talk to them and say here’s another scenario where that might give them a little leverage to bump it up on their product roadmap.
Amanda Streeter (08:25) And specifically, Tamara, right now, you can’t submit a provider while a location is pending, is that yes? Okay. Yeah.
TamraOhnesorge (08:36) And like, you know, we’re adding new groups. And so when we have those, if there’s a demographic update, like let’s say complete hometown has things tied up in a bulk demographic update, we can’t do anything else because that one’s tied up, it says there’s already one in progress for endeavor for that payer, which I.
Shannon Costine (09:00) think is and Vanessa would agree it’s crazy. So.
Vanessa Persha (09:05) Our systems logic today is that if it’s the same group…, name, payer, state and lobs… it will automatically block the system like recognize it as something that’s already in process. So that will be something that Shannon and I can take back. Like, you know, they’ll have to work through altering that logic to allow additional submissions to come through. So, but Shannon and I can definitely take that back and see if they can bump that up on their priority list.
Amanda Streeter (09:44) I would consider that pretty significant urgency because I mean there’s at least five de novo locations in the pipeline right now and another acquisition. And I lose track at this point like that’s a lot of growth and it’s all under one tax id number and one line of business. And that will not change for us as an organization that’s standard growth for us. So the system has to be able to accommodate that yep.
Vanessa Persha (10:15) Okay. Shannon, let me know if you need some help drafting that for the tech support, product feedback, yeah.
Shannon Costine (10:21) I will for sure. When we get done here, I will send that over. Okay? On rbts. I know the issue came up with caqh. They had already removed the education requirement. I didn’t even think about caqh not being needed. I did let them know, please make sure that you don’t request caqh because they’re not going to have one. So they are putting that in. So it shouldn’t be a requirement for you. And they pushed the one through that you, I think it was branding was that the last name that you asked about… got a lot? So you should be good on that one? We.
TamraOhnesorge (11:00) Have a question about caqh. I know way back in the way back when we were still looking at medallion, one of the discussions was that when we link their caqh, it pulls all that data. I can’t think of a single provider that it’s pulled complete data. We have to go in and fill in the same blanks. And the information I’m filling in is in caqh because you can’t attest caqh like without their start date and graduation date, those don’t hardly ever pull over.
Shannon Costine (11:36) All right. Start date. Vanessa… do you think we can just send that over or do you think we need specific fields because it should push and pull both ways?
Vanessa Persha (11:48) So from my understanding when you resync the caqh profile, you should be given the option of like what information you want to pull over into the medallion profile. Are you not seeing those fields as options to import? I?
TamraOhnesorge (12:06) Accept everything. So if it says, do you want to import this data, I say yes to all of them and then go back and fill in those. Okay?
Vanessa Persha (12:18) Let’s see if we can reach out to the product team, Shannon, this would be the spacs, product team. Okay? And find out what fields because I know that it does not pull 100 percent of the fields from caqh. Let’s find out exactly which fields get pulled over. I thought start date was one of them. So we may have a bug if it’s not importing it.
Shannon Costine (12:44) That feels like one of the top fields we should pull. Yeah, okay. Start date, and.
Vanessa Persha (12:53) I apologize. I’m in the background looking at your account at all these different little things. So I’m not paying attention. I’m just trying to dig into some of these while you’re talking through them.
Shannon Costine (13:04) Okay. On next issue that I have is for sunshine… disclosure of ownership. I took off the, we shouldn’t be asking for a disclosure of ownership if it’s you already have a contract. It’s just you’re just adding a provider. So I’m actually asking them to update our own internal instructions as well. But because our internal instructions spell that out, I had to put it on your project plan to say for sunshine, do not ask them for this. These are the only items that you need. I think it even says it on the website that you don’t need it. If you’re already contracted on that.
TamraOhnesorge (13:40) One that I sent where they submitted it incorrectly multiple times, sunshine is telling them here’s. The link go to this website. Don’t send an email anymore. Here’s. The forms that you need. They provided those forms and it continued to be submitted wrong. And I still don’t know if today it’s been submitted correctly?
Shannon Costine (13:59) Correctly. Okay. We’ll check into those again… to make sure it has. So you don’t have to, and I’ll let you know for sure.
Vanessa Persha (14:12) Shannon, do we have an example of the caqh, the provider whose start date is not filling in?
Shannon Costine (14:19) I don’t Tamara, do you possibly remember one?
TamraOhnesorge (14:23) Like their graduation start and graduation date? I just filled those out based on their resume.
Vanessa Persha (14:29) Okay. I’m looking at just a couple of like your newer providers and some of them have a resume import instead of caqh. Some don’t have any import. So I’m just trying to find one that has a caqh import.
TamraOhnesorge (14:45) And is there work around when the resume because a lot of my resumes won’t sync, it says you can’t use that and it’s a PDF. So I don’t know why… yeah.
Vanessa Persha (14:58) It should be able to read them. I mean, if they’re grainy or the text is not legible, I could see that, but if it’s not.
TamraOhnesorge (15:06) Yeah, they’re good copies. I know we sent some to Tracy early on and so she somehow got the resume linked but we’re trying to link them by and large. I just have to pull the information and enter it manually. And with as many resources as we have. I don’t have time.
Shannon Costine (15:22) Yeah, you shouldn’t have to do that. Maybe.
Vanessa Persha (15:25) We could grab some time with you, Tamara, separate from this call to just let you do a demo for us so we can see what’s happening. We can take some screenshots. And then if we need to submit a bug ticket, we can, okay?
Shannon Costine (15:42) Last issue that I have on my list, Tamara that you submitted over was blue cross blue shield, North Carolina. They, it looks like this one they are still looking into, but I, they did say that they confirmed that they’re using the medallion email on the apps. It says only providing the clinic email when asked in regards to the clinic.
TamraOhnesorge (16:06) Okay. Because if it gets to the actual clinic, we don’t always get that documentation and I would hate to miss something because it went to a clinic email would.
Shannon Costine (16:15) You prefer that they use your email on the clinic email spot, not your email specifically, like is there an like an admin email or a?
TamraOhnesorge (16:23) Lot of that when they’re asking for the clinic email is for visibility when they list the providers for members to see. And so, if they’re going to contact for scheduling or anything like that, it needs to correspond with the clinic. But anything credentialing does not need to go to the clinics.
Shannon Costine (16:40) I’ll reconfirm that with them to please make sure that they are not, you’ve got way too many clinics for them to just be throwing that in there.
TamraOhnesorge (16:51) That.
Shannon Costine (16:52) was all of the issues that I had on my list? The only other question I had was for Lindsay, do you have an updated spreadsheet?
Vanessa Persha (17:02) I sure do, I’ll send that over to you?
Shannon Costine (17:04) Okay, perfect. I’ll make sure that they go through that when these are being.
TamraOhnesorge (17:09) Released. If it’s a medicaid or a medicare, are those being moved to client owned? Or are they just being moved off fold for medallion to work?
Shannon Costine (17:17) They are currently just being moved off fold?
TamraOhnesorge (17:20) So, we’ll have to submit a ticket for any medicades that have been moved off fold.
Shannon Costine (17:27) You guys are doing those? Is that what you’re saying?
TamraOhnesorge (17:30) We’re doing off care medicaid. So.
Shannon Costine (17:32) We need to put those in client owned. Yes, I can have them do that. Okay?
Vanessa Persha (17:40) And that would be anything? Excuse me that’s sitting in a requested needs client attention on hold or in process status? Okay? There?
Shannon Costine (17:51) Was about two, a little over 200 that were moved off last week, I think so. We’ll need to look at those. But the ones that we release whatever Lindsay sends over, I can have them put them into client owned. Okay, just for.
TamraOhnesorge (18:05) those two financial classes?
Shannon Costine (18:07) Okay. Yep. Anything else? I mean, we have a lot going on?
Amanda Streeter (18:14) Yeah, I understand. I may have missed a call and maybe this was addressed. So, apologies, but there was an audit happening of our records. Yep. What’s the status of that?
Shannon Costine (18:26) So, what I’ve got is.
Shannon Costine (18:45) Let’s see. No, I apologize. I do not, they have 268 apps that they’re still auditing for the ones that Manpreet was handling. I do not have the update on that yet. I will follow up with that today. I should have something today.
Amanda Streeter (19:03) Okay. And then I think everybody cross your fingers and toes that I will have npdb wrapped up next week. Yay.
Shannon Costine (19:13) Yay. Last.
Amanda Streeter (19:15) Item is they want a wet signature on something? So like God help you, if you sign electronically, I guess, but yes. So what does that mean for next steps? Do I need to do something then, or do I just let you guys know?
Vanessa Persha (19:29) Yeah. So, who did your implementation?
Vanessa Persha (19:33) Was that? Naomi? Or Connor? Oh gosh. I forgot Tracy, did it. Let’s get Shannon, let’s get Naomi looped in. I know she’s really good with setting up the npdb accounts. There’s something she has to give you like our npdb account number or something like that to you guys have to accept something. It’s been a long time since I’ve done an npdb account, but I do know it’s a pain it.
Amanda Streeter (20:02) Does not surprise me at all that it’s a pain. Yes. Okay. I figured I would start asking sooner.
Shannon Costine (20:08) I’ll put, I’ll send an email to Naomi and copy you, Amanda, and then just have her tell you anything that she needs to make that happen.
Amanda Streeter (20:15) Okay, great. Thank you. Appreciate it. That was it for me. Okay?
Vanessa Persha (20:19) Perfect. Your cred files will move so much faster. Now. This will be great.
Colleen Simpson (20:23) Yay.
Amanda Streeter (20:24) Wonderful.
TamraOhnesorge (20:25) Wonderful.
Vanessa Persha (20:26) Awesome.
Shannon Costine (20:27) Tamara, anything else on your end? Are you sure… every day? I see her poor email? I’m like, God, poor, Tamara, I feel terrible. I wish I could fix it right away for you, but we’re working through it. I know.
Vanessa Persha (20:46) I’ve said this before, but Tamara, I just love your hair and I just, I look at it every time it’s so beautiful. I’m like I want hair like that?
Shannon Costine (20:55) It’s beautiful. Yeah… Colleen or Lindsay, do you guys have anything?
Colleen Simpson (21:03) I don’t have anything this.
Shannon Costine (21:05) Morning… Colleen. I don’t know, I’m.
Amanda Streeter (21:07) good. Thank you of.
Shannon Costine (21:09) Course. No problem. I don’t know if you were on when I was talking about the optum united issue?
Colleen Simpson (21:15) No, I think I missed that. I was having WI fi issues this morning. Oh.
Shannon Costine (21:18) No worries. I added that to every place I could, the list that you sent over. So, I told them if you see anything any like continued issues to please, let me know.
Colleen Simpson (21:29) Okay, great. Thank you.
Shannon Costine (21:30) But there’s no reason why they should not be submitting those properly moving forward. Okay? All right. So, I will owe you an update on the audit, and then I owe you an update on the caqh issues. We’ll probably do a follow up Tamara on that and see if we can take a look at that. All right, guys. If you need anything else, please let us know and appreciate you. I hope you guys have a good weekend, thank.
Amanda Streeter (21:57) You, you too.
Vanessa Persha (21:58) Thanks. Bye bye.