Transcript
Connor Morley (00:00) I mean that?
Rick Vance (00:02) Should.
Connor Morley (00:03) be pretty quick in order to get that done? And the list of the 61 payers is… everyone except for those 19 payers to remove from the part list, right? Or the 19 providers to remove from the part list?
Rick Vance (00:22) Yeah. The list that we sent out, okay, to take off a bunch of the docs that had signed with us since January of 25, we’re pretty confident that their enrollment is active and we have no issues. And obviously, we’re getting claims paid. So, we just thought we would focus on the ones that might be getting a little bit closer to the three years.
Connor Morley (00:46) Yeah. I mean, that makes total sense. Okay? So, I think we have everything we need for, the actual enrollment requests and the par analysis just to put it into perspective.
Connor Morley (01:00) Once we find out about the payers sometime, you know, I think we talked with Nicole last week, it could be pretty quick. We’ll let you know. We’ll submit a task for your org admins to let you know, like, hey, we found out about this. If there is an existing enrollment and we get the revalidation date in, we’ll put that in there. But if there’s not, we’re also going to let you know and basically say, hey, do you want us to follow up and submit a new enrollment for that payer? Yep, immediately. So the,
Rick Vance (01:34) answer to that is, yes, that’s okay.
Connor Morley (01:40) Okay. We can talk with the bar analysis team to make them aware like as soon as they hear that, we just don’t even need to wait for an answer and you just want to re, enroll them as soon as possible. Yeah.
Rick Vance (01:54) Yeah. I mean, yeah, I mean, if you want something in writing, you know, you can shoot me a quick email, okay? But,
Connor Morley (02:01) yeah, I might just do that just in.
Shannon Costine (02:04) case the answer is just do it and make it happen.
Rick Vance (02:07) Yeah.
Shannon Costine (02:07) Yep. Save you some money, and,
Connor Morley (02:10) then, Shannon, I think you wanted to talk to Nikki about some of the current, oh,
Shannon Costine (02:15) yeah. So it just seems like there are some questions about what you’re doing, Nikki, versus what the admins are doing. I just want to make sure that they’re aware of how the process is going to work and that they’re getting the right, asking the right questions. Are most of the office admins handling tasks or how are you working that?
Nicky (02:37) Yes, they are.
Shannon Costine (02:41) Okay. So, you have an admin in all of your offices handling tasks? How many are there?
Rick Vance (02:53) Nikki, you’re logged on twice? Oh.
Nicky (02:56) Okay. I’m going to get out of here. One admin typically per office. There’s one that has two offices, but it’s typically one admin assigned by location.
Shannon Costine (03:10) And they’re working tasks. Did you provide training to them on how to use the system?
Nicky (03:19) Yes, we.
Rick Vance (03:21) Did we?
Shannon Costine (03:22) Did to all admins? Connor?
Connor Morley (03:24) Yep. And we did two trainings with all the admins and gave them the recordings.
Nicky (03:32) As well if they had any questions.
Shannon Costine (03:35) Okay. All right, perfect. That helps them just to know who’s handling what, but for the most part, they’re just handling what the provider’s information and getting that put in.
Nicky (03:48) Correct.
Rick Vance (03:50) We did the payers.
Shannon Costine (03:53) Got it. Okay. So they don’t need to do anything for that part.
Rick Vance (03:58) Not at the moment. I don’t know that all of our payers are in there, but we needed, we spent a day and a half loading it because we’re way behind.
Rick Vance (04:07) I think on, we probably should have done this. What is it? April? Yeah, we should have done this probably the beginning of February. Yeah. So we just need to make sure at this point that your data with what’s in there, that your database is up to date with the payers. So as you get updates, and as you look at caqh, you know, is, do we have a really good solid correct database? Have we built it and is it up to date?
Shannon Costine (04:42) Got it. Okay. Connor, that was all I had for today if you have anything else?
Connor Morley (04:50) So why don’t we check really quickly some of these payer… requests just because I do see that there are a good amount that are in the stage of needs client attention. And I see, I want to make sure that our team is getting the right information and, you know, everyone’s talking the same language. So right now, just… let’s do this. Maybe Shannon, you and Rick and Nikki can go through this maybe like once every two weeks or so just to take a look at the dashboard, make sure things are progressing appropriately. And I say every two weeks because our typical follow up time with all the payers is about once every two weeks reason being sometimes there’s not a whole lot of movement. We… there are some payers who will flat out tell us, please don’t respond, for another, you know, 30 days because that’s just our timeline, but we still follow up every two weeks anyways. So with the list of ones in processing, you know, we have a good amount that we’re just waiting here back from the payers.
Connor Morley (06:12) And I’m not worried about any of these. They’re moving forward. We’re looking good. You know, once we find out about the payers, the validation date, the revalidation, all that will be updated in the system, it’s, these needs client attention that I am a little, I want to make sure that we have everything that our team needs. So when you see for example, this needs client attention right here, it looks like we just have a provider tasks, and you can see if we open up… this payer line specifically for Francisco aguilo Sierra. It looks like we need for sometimes we need end user access or surrogacy. And Shannon, I’m pretty sure this is a surrogacy request for this provider, right? Yeah. So if I open it up, we give them the information right here. So typically, what we’ll do is our team will reach out three times. And if we don’t hear back from a provider, and then we’ll tag Nikki, you and the org admins to help us get this provider to give us, the information that we need.
Nicky (07:29) Connor, they don’t have access to Pecos or the Ina, can these be routed to me? Yes?
Connor Morley (07:35) They can, so… Shannon, let’s take that as a follow up for any medicare end user access to have that be an org admin task instead of a provider task? Okay? Got it. All right. So we can reroute that to org admin. And then I just want to take a look at some of the other ones to see what kind of tasks we’re looking at. If they are all medicare end user access, then we’ll just reroute those to… admins. So in the provider, those look like that. There are some where we have a profile. We need someone to sign their authorization agreement. This person didn’t sign it. So it’s a helpful little piece on your end. If you to go through some of these provider tasks and see, you know, what are the ones that are really like far outstanding like some of these, are pretty old. So we want to make sure that we’re getting and making some progress on these. And we’re still following up but I want to make sure that these are getting closed out. So if the provider did give us this information, all they need to do is mark the task as complete, hey?
Nicky (09:03) Connor, while you’re in there, can you look at something under the payers? Sure.
Connor Morley (09:09) The.
Nicky (09:10) act the payer, health first. If you go down a little bit, that specific payer?
Nicky (09:26) I’m not sure why there’s more pictures showing up? I just clicked on payers to the left and then selected health first from the list.
Connor Morley (09:37) Sure. We can, we can do that too. Health first.
Nicky (09:45) Yeah. So, can you scroll down? Sure. So how come Frank Sierra is on here twice? It’s the same plan.
Connor Morley (09:59) Frank Sierra right here. And then Frank Sierra.
Nicky (10:05) That.
Connor Morley (10:08) is a good question… provider start date? Why is this blocked?
Connor Morley (10:25) Could it have just been an error that was put in twice? This could be just a duplicate. I just want to see.
Connor Morley (10:38) Let’s see intake, completed request owner. This was created on April third and this other one was created on March sixth. So I’m feeling this is just a duplicate, we can always just delete this one because it does look like it’s a duplicate and our team’s not working it because most likely it’s a duplicate. Okay?
Nicky (11:01) So,
Connor Morley (11:02) if we want to delete that, I mean our team has not worked it, so we can kind of just cancel it or just.
Nicky (11:13) let her know. I get what happened. Yep. While you’re on this page, I had another question about somebody yep… maravick, quintanilla… it says she’s being enrolled at two practices, but she’s only at one and I don’t know how to get the… wrong practice off her profile. So here, these are her practices. But when you go back to her enrollment, she’s attached to go on this Gi. And I don’t know how that?
Connor Morley (11:55) Is, yeah, I see two practices here… one second, Gomez. Gi. Yep. So you want us to delete that? So what we can do for this one, because I think this one, yeah, this one’s already with the payor right now. So enrolling them with two practices doesn’t necessarily cost… any. It’s not an additional cost, but what we can do is essentially… once this is finished going through the payor, we can just request a single demographic update for… that. And for, was that ambit or healthfirst? I didn’t see, I think.
Nicky (12:46) It was healthfirst but I’m not understanding why it’s coming under her profile when she’s not listed on that practice and it’s not attached to her profile. Yeah.
Connor Morley (12:58) So sometimes during a, when you make a request and let me just pick something randomly, you can choose, I… don’t know. I’m just going to choose Edna. You can choose multiple.
Connor Morley (13:23) Or I’m just going to choose Edna and health just for the sake of getting showing, you can come on, you can still choose multiple practice associations. So most likely, what happened is this was just so she has the two Brevard locations linked to her. This might have just been a mistake where Gomez was clicked. Instead. Was this a provider that recently moved from Gomez? Yeah, she.
Nicky (13:53) Moved from a practice called space coast, but that’s now called. Okay. That makes sense. Oh, that makes sense. Now, it’s called Gomez Gi. Yep.
Connor Morley (14:05) So that was probably why we can just do a demographic update once that’s been done. Okay. All right. Any other questions on the payers?
Rick Vance (14:22) So, I think I’ll send an email out saying follow up on the, you can go back to that screen. It’s admin tasks.
Rick Vance (14:36) Yeah. I think there was another screen where you could get to it here on the overview. Was it providers or payers? Yeah, payers?
Connor Morley (14:47) Yeah. So payers, so we look at the enrollment requests… and the key needs client attention. Yeah. Okay. We just want to make sure that these are filled out and that these providers, if we reach out to the providers, we can change them to be org admin requests. If that’s easier.
Rick Vance (15:09) No enrollment requests. And then that needs client attention. Okay? I’m going to send an email out today?
Shannon Costine (15:20) Okay. I.
Connor Morley (15:22) will say as well for the, if, who are you sending the email out to?
Rick Vance (15:27) The OAS got it. The office administrator, yep.
Connor Morley (15:30) Perfect. I was going to say that the, for the OAS themselves, they should only see tasks that are associated with the group and providers with the providers of the group that they’re assigned. Okay?
Nicky (15:50) Connor, do you know what the action is that’s needed for those Ina connections?
Shannon Costine (15:59) Yeah. So you have to go in and do we do it? Normally, it’s you have to go in and accept the connection. So, if we request it, you have to accept that connection once you log in.
Nicky (16:13) So, if I’m not seeing it, is it being sent to somebody else’s?
Shannon Costine (16:18) It times it normally times out within 72 hours, but if they’re sending it directly to the provider, then you have to log into that provider account.
Shannon Costine (16:32) You would have to accept the connection through the provider. Now, do we have surrogacy access to your group as a whole?
Nicky (16:41) I am connected to all the providers. Do you want me to add you as a surrogate?
Shannon Costine (16:49) Yeah, you can do it that way as well. Connor, did they attach instructions in the notes she usually does? Yeah, they.
Connor Morley (16:56) did, yeah.
Shannon Costine (16:58) In the notes, you should see the instructions and it’s it should be both ways where you could put our email address or we put yours. If that doesn’t work, just let us know. Okay. And I’ll let Jill is the one who usually puts it through. I can tell her to process it again today.
Connor Morley (17:21) Okay. And then just so what you can see on the provider side… they’ll get a task. We just need to make sure that they mark it complete. Once it’s done. Okay.
Shannon Costine (17:46) Yeah. Okay. I just sent her that note to re, request it. That’s a handful. Mouthful.
Shannon Costine (17:58) Any other questions?
Rick Vance (18:02) That is a, that is a good start. We should clean it up. So, any more clarity on your part from what we would prefer or asking?
Shannon Costine (18:16) From me or from Connor? Sorry?
Connor Morley (18:18) Both not for the par requests. I think I might have a, just a follow up on the lines of business for those payers that you’ve assigned. Like if there are any. So it’s united cigna and medicare, Florida, blue cross blue shield. I’m assuming commercial for all of them. And then just if there’s medicare advantage or that flows.
Rick Vance (18:47) So, I’m not worried about those. Yeah. Okay. Sounds good. Just, I mean, it’s if there’s a cost associated with it, not more than what we approved, and do I need to sign an amendment or anything you should?
Connor Morley (19:02) Jack?
Shannon Costine (19:04) Just sent an email while we were all on this call. It says that he sent something over. Is that what you’re requesting for your contract?
Rick Vance (19:11) I was wondering if I needed to sign something. So, let me take a look. Yeah… you did contract has been sent for your signature, yep I got it. So if… you have issues with accessing the email now, I’m traveling today. I do not hesitate. Okay. I’ll look at that right now. Okay, perfect. Okay. Thank you both. You know what? I should mention? One other thing we were on our south Tampa call this morning with dr Delgado and there are some of those items that they needed to be clear as to what they’re and again, they’re a new group that just started in March. I think they were going to reach out to you, Shanna to try to connect and work through that, that’s Kathleen and Awilda. So any guidance you can give them to work through those items, obviously that’s a new provider that has not been credentialed with us before. So, I think a lot of his credentialing is still in flight.
Shannon Costine (20:19) Okay. Yeah. She was the one that I was referencing that reached out. So just wanted to make sure that it wasn’t something Nikki had already done. I’m assuming she’s just asking questions on his tasks on what we need from him the.
Rick Vance (20:34) Admin ones. Yeah, because a lot of those admin items, it sounds like it’s corporate, but it’s really not now, you did clarify. I think some of those outstanding softwares that we needed that need to go to Nikki. But for the most part, a lot of those admin things are either the doctor has to attest or it’s something that they still need to do or they did it and they need to market complete it. So if you could work through theirs, they’re just a new group. We’re trying to get up on their feet in totality. So, it’s pretty critical for that office.
Shannon Costine (21:04) Now, they are, this is John Delgado, correct?
Rick Vance (21:09) Correct now?
Shannon Costine (21:11) Connor, some of the stuff that they’re asking for is group prerequisite. I’m assuming is that for the location that they’re asking for?
Connor Morley (21:21) Hang on one sec, practice location, which practice location are we referring to?
Rick Vance (21:28) South Tampa?
Shannon Costine (21:30) Please update on this. That group is enrolled with evolutions healthcare system prior to enrolling. The payer. Okay? So they’re asking specific questions based on the payer, I can show her how to take a look at each of these lines. Okay?
Shannon Costine (21:52) So, do you know, has the location itself been enrolled? But if they’re falling under your tax id? No?
Rick Vance (21:59) They.
Shannon Costine (22:00) haven’t, I.
Rick Vance (22:01) mean, they’re new as of March. So every communication with the payers is going to be since March, so.
Shannon Costine (22:09) The location needs to be tied to your agreement, but same tax id. So there’s no reason why we can’t move forward with those. Yeah. Okay. And.
Rick Vance (22:20) Then anything you hear about dr ditomaso and Carolina or Carolina, they were coming up as out of network with Aetna. They are very busy providers for us. In fact, dr ditomaso. I think, you know, is the chairman, we don’t really want to egg up with those guys. So if we have to re, enroll, just let us know what you find out about those two… with all of their credentialing. I’m a little concerned that they’re out of network and that we have to re, credential them completely. Yep.
Connor Morley (22:57) We will let you know about those. Yep. Ditomaso and Carolina sync.
Rick Vance (23:05) Go ahead. Sure. Yeah. Okay. All right. I’m signing the agreement. I just hit finish. All right. Perfect. Okay. All right. Thank you both. Thanks guys.
Shannon Costine (23:20) All right. Bye bye.