Transcript
Lpetitte (00:00) hello morning.
Jason Zednick (00:02) Morning. How is everyone?
Lpetitte (00:06) Pretty good. How are you?
Jason Zednick (00:08) I’m okay. Okay.
Jason Zednick (00:15) I always go for a longer weekend.
Lpetitte (00:17) But yeah, yeah, that’s true. Didn’t happen. So, no, this one did seem to go by kind of fast.
Jason Zednick (00:24) Yeah.
Lpetitte (00:28) So, we can get started. Jason Dwayne’s out of the office this week.
Jason Zednick (00:33) Yeah. He did say he might try to come to this call, but, I’m not.
Lpetitte (00:39) Well, I hope he.
Lpetitte (00:40) doesn’t I hope he doesn’t yeah, I hope he doesn’t I hope he stays on vacation. He needs it. Yeah.
Jason Zednick (00:47) 100 percent. All right. So, I did want to follow up and ask about the licenses that we discussed on Friday. I assume advocare… decided to manage those internally. I just want to confirm that.
Lpetitte (01:07) Yes, these are, the medical licenses for like there’s like 10 providers or I think there was 10 lines, it’s not 10 providers.
Jason Zednick (01:15) Yeah. Is that what you’re referring to? Yeah, right.
Lpetitte (01:20) Yeah. I’m working on that. Okay. All right.
Jason Zednick (01:24) David’s the hero on that one. Okay. All right.
Lpetitte (01:36) Can I ask a question about, yeah, about someone? Maybe if you know what? I can probably just pull it up? It’s we had a care center. Let me share my screen. We had a care center reach out to us.
Lpetitte (02:00) Here we are in medallion, you know, requesting an update in the status of this new person that’s starting on the fourth of may and I just want to get some clarity into the notes for medicare… and, you know, maybe Dawn or Tanisha might be able to help with this too. But essentially, the notes here say placed in line. Hey, hold on. I copied it. Sorry… it says placed in line pending dependency. Dependency… group line is in intake, status, provider will be enrolled once group enrollment has started. So my, I don’t know only because I’m this… is medicare. Why wouldn’t it have been started already? Is it because they have to wait until the provider is actually working in advocare, which would be may fourth.
Jason Zednick (03:11) No, it’s the location that is being added is not on file with the group and we require the location to be on file before we can, you know, link the provider to that location.
Lpetitte (03:30) Okay. So help me understand linking a location. Is that something we need to do? Or is that something medallion is handling?
Jason Zednick (03:39) Well, let me take a look here. So, Heather… I,
Lpetitte (03:44) have a question about that too because, you know, the other providers that have worked there are par with medicare and they work at that location. So, I’m wondering how the location could not be there. You know what I mean? Like they’re working. They’re presently getting paid by medicare at that location,
Jason Zednick (04:04) So, it’s possible and this is one of my projects. I just haven’t had time to, complete… it yet. It’s possible that the location is on file with medicare, I, but the, but we don’t have that record in medallion. Okay. So, so our teams don’t know that and I am working on aligning the locations in medallion and matching them to your medicare id report. So we can true that up. Yeah. I’m just not there yet.
Lpetitte (04:40) Okay. I’m going to go with that’s. Probably the case because there’s one, two, three, four, five, six, seven, eight. There’s like nine providers here who’ve worked here for since like 2012 and, you know, they have, they do have medicare as a par payer, they’re getting paid. So it’s got to be there somewhere. You know, yeah.
Lpetitte (05:04) So, so that being said, there’s healthspring and clover, and my assumption is it’s all dependent upon this medicare… right?
Jason Zednick (05:19) Yeah. Hold on one second. Can you scroll to the right? Yeah, you can hover over the blocked. The column says blocked skeletal orange dot. Yeah, it’ll tell you what it… is… pinned to, what it is dependent upon. So that one is dependent on the group enrollment to add the location. And then if I go down to the healthspring, take a look, yeah, it is pendant to the medicare enrollment. Yes.
Lpetitte (06:10) Right. Okay. So when can we expect this to be resolved? So this provider can actually, you know, accept medicare by may fourth.
Jason Zednick (06:27) I’d have to check on. Let me see.
Jason Zednick (06:49) Yeah. So that request to add the location is with medicare. It was submitted on the first. I don’t have a good personal sense of how long medicare processes these things. My instinct is to say it shouldn’t take that long. So they’ve had it for a couple of weeks and so as soon as that is on file, then we will push the request… for Heather, yeah, right. But.
Lpetitte (07:20) If the location is actually on file, why are we requesting it again? I know you don’t know, but is there a way we could check that first before, you know, request it again? Like because like I said, these providers have already been here. They’re par with medicare. The location has to be, I mean, Dawn Tanisha, you guys might know more than I, but the location’s got to be on file. We had to have linked them to something somewhere in the past the.
Lpetitte (07:46) Location actually doesn’t have to be on file. Okay? This, this is like a medallion process. So in the past, we would just link them. We’ll just keep it moving because everything is so brush here. So it is very possible that the location was not enrolled.
Lpetitte (08:07) How would you link them before? Like where would you link them previously? Just so I know, you know what I mean? You.
Lpetitte (08:13) Would just link them to the tin, you wouldn’t necessarily put a location.
Lpetitte (08:17) Oh, okay. All right. That.
Lpetitte (08:20) Answers that makes sense. So, in the past, you would just link them and they would be par and everything would be just fine, but.
Lpetitte (08:28) Medallion, yes, but that’s not in compliance with what medallion does. So that’s what I’m saying, yeah.
Lpetitte (08:34) Okay. So you would link them to the tin and whatever addresses were under that tin. Medicare is medicare since we’re a group? Yes, it didn’t seem to be an issue. Okay? Right? Okay. Got it. Okay.
Lpetitte (08:49) So, that explains that because I know the care center is going to come back. Yes. When I provide them with this spreadsheet, they’re going to come back and they’re going to say, well, what, you know, what is?
Lpetitte (08:59) Going on? Yeah, they’re going to ask the question. I asked how we’ve been billing this whole time and we’re par with medicare. Why is it suddenly a problem? And again, like you said, you don’t know that might be on file. We don’t know, I’d hate for you guys to do extra work if it’s actually on file, right?
Jason Zednick (09:19) Right. Yeah. Because if it is on file, then we, then you don’t have to do that, right? Exactly. Yeah. Let me see if I have let me pull up my worksheet. Yeah.
Lpetitte (09:30) If you have an address, I can give you the address that the office is at to see you.
Jason Zednick (09:36) Know, yeah, exactly. Yeah… or I can.
Lpetitte (09:40) Give you the address and you can check your sheet that’s rather than, you know, running through them all obviously.
Jason Zednick (09:47) Yeah. So just one second.
Lpetitte (09:57) Thank you, Tanisha. I didn’t know that now. Yeah, that helps.
Jason Zednick (10:11) It looks like the address is 23, oh one, east evesham. Yeah.
Lpetitte (10:18) Yeah, 20.
Jason Zednick (10:20) Three to one.
Lpetitte (10:24) East evesham road. Yeah.
Jason Zednick (10:42) Yeah, that address is on file in your medicare id report.
Lpetitte (10:48) Good. That’s good news. Yeah.
Jason Zednick (10:54) Yeah. So one thing I can do is, I can bring that to my team, show them the medicare id report, be like, hey, this address is already on file, let’s just even though medicare is like adding it again, quote unquote. I’m not exactly sure how to handle it on the medicare side, but we can close that request, record the enrollment to say, hey, this location exists. We can use the previous effective date, whatever that was that’s on the medicare id report. And then that will unlock anything bended to that request line? Perfect.
Lpetitte (11:31) There you go.
Lpetitte (11:35) And then they’ll go ahead and start the medicare.
Jason Zednick (11:39) Yeah. They’ll submit that and I can tell them too, like, hey, like, can you like bump this one up to the top of the line? Okay? Because I’m going to ask about it. Yeah, that’s cool.
Lpetitte (11:48) Because I made a spreadsheet that I’m sending to the care center and I’ll just update that, and then I’ll update the other two that medicare started and the other two will follow after. Yeah. And then.
Jason Zednick (12:01) just so you all get a sense of what I’m doing on my end and it’s been a little hard for me to make progress, but I am working on it is, I pulled your medicare… id… report and sort of split the addresses out so that I can separate them into data. So like these are the address, this is the address information from the practices on file in medallion, right? That’s what these columns are, right? And then I sort of did some further splicing for matching purposes. And then this is the entry in your medicare id report. Yeah. Okay.
Jason Zednick (12:48) I see. And what I’m doing is sort of looking be like how many potential matches? Is this a match based on basically the street address? Number? Yes. And there’s like a suite included and I just got, I just got to work through. I see the remaining because we only have like I’m going to make up a number 15 or 20 or something on file? It’s actually way less than our on file medicare. So… and I.
Lpetitte (13:14) see, you know, you see the address, and then you see the actual group like advocare endo of princeton, that would be endo of princeton on our end. Okay? I see sometimes there’s a clue there in the actual address that’s in the medicare file. So, exactly.
Jason Zednick (13:27) Yeah. So, once I figure out how to like split the numbers out, the matching is actually pretty easy. I just need to like go through it. Make my like, I think this is a match, yes. And then I’m going to put in front of y’all and just be like confirm, yeah, absolutely. And then I go to my team and have them just load them as existing enrollments and then we have it. So.
Lpetitte (13:49) Okay.
Lpetitte (13:51) So, when will they submit for this enrollment? Then, Jason, will they do that today for medicare? I?
Jason Zednick (13:59) Can’t guarantee today? But I can… put all this information in front of them and then make sure it happens in the next couple of.
Lpetitte (14:09) Days. Yeah. Okay. And then if anyone could just answer this once you put the enrollment in, the date you put it in, is the date that they, once it’s approved, that’s the date that they’re actually effective, correct? Dawn or Tanisha, you guys probably know this.
Dawn Candia (14:31) I mean, not necessarily. We typically put it in a, 30 days prior, but, you know, to give it effective date, but, yeah, they’ll give what typically, they’ll give whatever effective date you ask for. Oh.
Lpetitte (14:45) Okay, good. So then, so, Jason, can you just have your team make sure they put effective date for, at?
Dawn Candia (14:55) Least their start date?
Lpetitte (14:56) May fourth, which is her?
Dawn Candia (14:57) Start date?
Lpetitte (15:01) Yes, this is for the medicare enrollment. And this way here, we know she’ll be par by then or even if we have to hold the, the claims you’ll be able?
Jason Zednick (15:10) To back that? Yeah, yeah, I’ll include that in my summary when I, yeah, write it up and submit? Yes, wonderful.
Lpetitte (15:19) And then everything else, I, you know, it’s they’re with the payers, if maybe you could just ask your team to follow up and, you know, because the provider starts, you know, may fourth if… we could, see if there’s a way for them to expedite anything. And I know Lisa and I were on a call with, ibc and amerihealth and I know there are some challenges there with credentialing on their side, right? Lisa. Yeah. So, everything’s in, it’s great that it’s in, but, you know, it’s on their side. It’s not on our.
Jason Zednick (15:56) side. Is that what they told you? Yeah.
Lpetitte (15:58) Yeah, they did it.
Jason Zednick (16:01) Yeah, they gave us, a pretty extended time frame. They were basically, they were like, yeah, you can follow up but not until after like 90 days. It’s pretty long.
Lpetitte (16:12) Yeah, I know. Yeah.
Jason Zednick (16:13) That’s that’s good.
Lpetitte (16:14) They’re trying to, I think Dwayne reached out. I think he’s trying to work on it with them internally to figure out what the holdup is, but.
Jason Zednick (16:23) Yeah, yeah.
Lpetitte (16:25) But in the meantime, if you could have your team check on the others, that’s the only thing that we know, yeah. Oh, I’d appreciate it. So, this care center,
Jason Zednick (16:36) Is it just Heather, is that just, the only new provider for them? It, it is okay.
Lpetitte (16:43) Yeah. And her email is they’re facing staffing shortages, and that’s why they really need her to be able to hit the ground running on the fourth got.
Jason Zednick (16:52) It, yeah. Yeah. I understand.
Lpetitte (16:53) That, and let me just add, just double check. The suite number is right? Because I think I heard someone mention that it was in Pecos?
Jason Zednick (17:06) Yeah. Yeah, it is. Let me, I still have my thing up. I can check.
Jason Zednick (17:17) Oh, actually, that might be different. Let me check 23. Oh one. Again… that’s a really good point. Tanisha… nope, suite one, two, two, yep, is on file.
Lpetitte (17:32) Okay. And it doesn’t have an end date. Oh, I’m sorry. Oh, because I just put it up and it looks like the address is on file. No, no, no, but it has like four, 15, 2014 as like an end date.
Jason Zednick (17:46) No, no, I’m sorry, I misread this. It is a different suite. I have the address, but I have suite five oh four and then this practice is suite one, two two. So that would not be a match.
Lpetitte (18:04) My.
Jason Zednick (18:05) apologies, I miss missed that… good pick up, Tanisha, but, it is, so what I have on file in medicare, is the women’s group, it is, but it is just a different suite number and I’m not, it’s not clear to me. They might have.
Lpetitte (18:25) Moved at some point, you know, if it’s a big complex that maybe that could have been what happened and we have the old one on there on file. Yeah, which is, but, yeah.
Jason Zednick (18:40) I would need to check with my team. I don’t know how,
Jason Zednick (18:48) How much medicare, how strict they are, you know, right? Like if it’s the suite number itself or not, I don’t know.
Jason Zednick (19:03) Either way, I’ll flag it and see what our options are for sure. Okay?
Lpetitte (19:10) Yeah. Can you just let us know on that one then?
Jason Zednick (19:12) Jason, yeah. Yeah, I’ll follow up. I’ll follow up for sure. Yeah, perfect. I appreciate it. Yeah, happy to. Yeah.
Jason Zednick (19:25) The only potential, yeah, there’s only one potential match.
Jason Zednick (19:44) And then similar conversation, Don, I got your email about the provider that they’re saying is already on file. I haven’t like pulled it up and looked at it yet, but if it’s already on file, then like, yeah, I’ll just have them, you know, close it out, record it and be done with it. Okay?
Dawn Candia (20:03) Dr. Uzen, yeah, dr. Uzen, yes. Yeah. Okay. And I went ahead and put that same note in medallion and marked that task complete just so, you know, it would.
Jason Zednick (20:15) Yes. Yeah. I saw that, which is great. Exactly what I would have asked and, you know, I would hope and assume that they would be like, okay, great. And then close it, but I will also just tell them to do that. So, yeah, so there’s no ambiguity there.
Dawn Candia (20:34) Okay.
Jason Zednick (20:45) What else? What other questions do we have?
Lpetitte (20:54) I don’t have anything else today.
Lpetitte (20:59) I don’t have anything either nope.
Dawn Candia (21:04) Nope me either.
Jason Zednick (21:04) Okay, great. So, I know Dwayne’s out this week. He and I are working into like a time with Bethany for the horizon piece. I’m not, it… seems like there’s a… challenge in getting like my team’s schedule to match up with Bethany’s but we can figure something out.
Jason Zednick (21:29) I am personally anxious to be like, yeah, let’s do it. I want to meet, I want to see what she’s doing. Yeah. So that is still top of mind for me, but yeah, we can come back to it next week.
Lpetitte (21:39) Yeah, Bethany works part time. I think Dwayne probably told you. Yeah, she starts later like I think like four or four 30 every.
Jason Zednick (21:46) day. Yeah, I think it’s five and what I’m running into is that my operations counterparts, their days end at four and so it’s just a bit of a mismatch, but we’re going to figure it out.
Jason Zednick (21:59) We’re going to figure something out so… wonderful. But we can talk to Dwayne when he’s back. We don’t need to bother him now, okay?
Lpetitte (22:10) One real quick thing, Jason, can you guide me to the Friday call? I don’t think I’m added in Lisa and Dawn. They send me invites, you know, when I ask them every week, but if you could just add me to the group, that would be great. This way here. I’ll always have it on.
Jason Zednick (22:27) My calendar. Yeah, for sure. Here you go. Friday, yes.
Jason Zednick (22:44) All right. Just sent you an invitation. Perfect. Thank you. Of course.
Jason Zednick (22:54) All right. Well, thank you all. Appreciate you joining today if something else comes up that you forgot about. Totally fine. Just shoot me an email. I’m going to follow up with my team on Heather and see what our options are… and, you know, sort of market a priority either way. And then the same for ozkin, I’ll get that moving for you, Don and that’ll.
Dawn Candia (23:25) be that okay? Thank.
Lpetitte (23:26) You. Wonderful. All right. Thanks, Jason. Thank.
Jason Zednick (23:29) You all.
Lpetitte (23:30) Bye bye.
Lpetitte (23:30) Bye.