Transcript
Adalee Arreola (00:00) hi, Adalee. Hi, Naomi. How’s it going?
Naomi Denson (00:05) Good. Do you have anything that you need to talk with them about their data or anything? Yeah.
Adalee Arreola (00:13) No, I haven’t been able to look at it. I’m going to look at it later today or actually.
Kimwaters (00:19) Probably tomorrow.
Adalee Arreola (00:20) But we do have this situation going on where we can’t import any data at the moment. Okay? But yeah, no haven’t seen their data yet. Okay?
Naomi Denson (00:34) Cool. All right. Thank you.
Naomi Denson (00:45) Hello?
Kimwaters (00:47) Hey, how’s it going?
Naomi Denson (00:49) Good. How are you?
Kimwaters (00:50) Good… awesome.
Naomi Denson (00:55) Jump in hope. Everybody had a nice weekend.
Staff (00:59) I want.
Naomi Denson (01:00) To share my screen?
Staff (01:02) For once, I actually didn’t work any over the weekend. It was kind of different.
Naomi Denson (01:09) Well, that’s always good. All right. Let’s see. So blisters.
Kimwaters (01:17) To prove manual labor. Does that count? Yes?
Naomi Denson (01:21) That counts. I avoided that, but still had to do some organizing.
Kimwaters (01:27) Flower beds and venetian plaster, which is interesting, just.
Naomi Denson (01:33) Saying, is that outside?
Kimwaters (01:37) It’s thicker than paint?
Naomi Denson (01:40) Okay. Yeah.
Kimwaters (01:41) So, anyway, yeah, by no means am I an expert, but I can tell you what not to do on a couple of things. I can tell you what not to do, trial and error, huh… all?
Naomi Denson (01:52) Right. Well, so, we have the npdb set up the custom provider invite. I know you guys are working on drafting that I got the logo.
Kimwaters (02:01) Yeah, we have, we met with a group today and are going to be meeting tomorrow again with a smaller team to get that finalized for you. I think this, so this is the invite that they’re going to get access to the system. So this is part, we’re also going to include the provider packet with this email, right? So this is going to be what’s going to go out of our like for new providers. This is going to be like what goes out of like with our from like our HR platform. So this is when this is the invite that you’re saying has to be done once for like old, like current providers and then we will redo it for new.
Naomi Denson (02:46) Providers, right? Yes. So, two drafts, one for legacy existing providers, and then after we get all of them invited, we can transition to the brand new providers and then keep it… with that invite going forward and.
Kimwaters (03:01) Then I just, I read through all of these again and obviously, like part of the wording we’ll be changing is just more like reminding them that they still have access to our team and the support they’ll have around that. But yeah, again, just to make sure like there’s four steps that they need to do here in another document, I think there were like five steps that they need to do. So like legacy providers, like how much work, how much of a lift is it going to be on them when they sign in? Because everything should pretty much be there, right? So, can you help me clarify like what legacy providers are going to have to do? So?
Naomi Denson (03:42) We’re setting up the caqh pdqs connection to import the caqh data to their profiles. That usually gets it to around 70 percent complete. From there, it’s making sure that all the other requirements in their profile are added from information that wasn’t in caqh or was expired in caqh and then signing their agreements and attestations on their profile.
Kimwaters (04:17) So what I want to clarify with like our group is the idea is that there’s not a big lift on our like legacy providers because we should have all of this information, right?
Naomi Denson (04:31) Yeah. So in admin users, I sent the invites out earlier. Anyone who’s an admin user can make any changes or adjustments to the provider’s profile for them ahead of sending the invites. And then it’s the only thing the provider would be required to do is sign the profile, sign the agreements.
Kimwaters (04:50) So, is there information that we have that is part of that like 30 percent that you say is missing?
Naomi Denson (04:57) Mostly going to be documents like license copies of licenses because caqh doesn’t require those and they don’t connect to the existing license records, board, certifications. Sometimes it’s like any yes, disclosure questions that they’ve answered? Yes to it’s then providing the explanation for that or any supporting documentation required. And then yeah, mostly just documents and signing of the agreements. Anything that’s not required to be provided in caqh. Typically providers will skip over and not give that, but it could possibly be a requirement in medallion. So just some demographic information that may still be… asked for?
Staff (05:50) Yeah, because I was, yeah, I was looking at the provider packet letter and some of the things that were listed on it and.
Staff (06:01) I’ve got, we’ll have a couple of questions on that when we get ready to do that too.
Kimwaters (06:06) Okay. We can go to that now, Monya… that’s part of answering. I think this question too. Yeah, part.
Staff (06:14) Of the basic information that’s listed, it says mailing address for information from boards and applications for medallion to be mailed to. Are you talking about you’re? Going to be mailing them applications to complete? No.
Naomi Denson (06:27) We’re not mailing them anything that’s just a demographic requirement in the profile. The only time we would mail them anything directly is if we’re doing like licensing work, but like if we had new licenses or if we needed a mailing address to put on a licensing application, not necessarily that we’re sending them anything directly, but if a payer asked for their direct mailing address or which is not that common for the direct address there or the licensing boards where they would ask for that information.
Staff (07:02) Okay. We make the providers themselves contact their licensing boards. We don’t.
Naomi Denson (07:09) right. So we’re not doing that work for you on their behalf. That wouldn’t be, it was just an example of why it’s in there.
Staff (07:16) Okay. Because we want everything mailed to us. We don’t want anything mailed to the provider.
Naomi Denson (07:21) Yeah. On all of the payer enrollment applications, we’ll be using the mailing address from the group profiles. Okay?
Staff (07:27) One of the items listed is npi and taxonomy code. And of course, you know, it on there, taxonomy code must match their profession. Okay. That brought up the question. Do you guys do any updates to their npi registry? Like when, you know, when they come on board with us, their practice location needs to be updated et cetera. Or do you depend on the provider to do that? So, with.
Naomi Denson (07:56) Npi registries. So when we’re doing enrollments and things like that, we’re going to cross check and make sure the taxonomy that’s in their profile matches with what’s in caqh, where payers rely on that, and also matches with the npi registry. If they are not all matching up, then there’s a task that will go out to the admins. I believe we decided to do admin tasks only for you guys. So we would task that out for you and request to update either platform with the correct taxonomy, whether it be their inpes. But we don’t manage their inpes account in any way.
Staff (08:32) Okay. That answered another question I had then because part of our onboarding process is we do manage their inpes for them. And so my other another question I had then because for you also are in here where you said that you do for Pecos for them and the surrogacy, will that surrogacy be set up where it comes under our primary… account so that we’ll have full access to that? Or are we going to have to ask for a second surrogacy?
Naomi Denson (09:05) Yeah. So the surrogacies that we request are to, are the specialists because Pecos, you can’t share logins. You can’t work under another username and password. So the specialist that’s assigned to those medicare applications would be the one getting the surrogacy.
Staff (09:24) Okay. So we won’t be able to see our people or?
Naomi Denson (09:27) Actually, it’s yeah. Well, it’s going to medallion and then we’re we’ll delegate the access as far as I, as far as I know, to our teams, but it does not connect with yours from my understanding. But what’s the link to your, is there a,
Kimwaters (09:43) main, is there like a main login that you have or do you just have a surrogacy for every individual provider?
Staff (09:49) We have a surrogacy for every individual provider, and then we have employees who work under our platform that they’re tied to us as employees?
Naomi Denson (09:59) What are they doing with the surrogacy current? Like what is the expectation for them to do with the surrogacy after we transition to medallion?
Staff (10:11) Currently, we do their Pecos and their npps… both.
Naomi Denson (10:19) Right. So you’re getting surrogacies, but what actions? Yeah. So we’re not getting surrogacy, we only request surrogacy to Pecos. We don’t request surrogacy to the npes side of it. When you’re requesting through Ina, you choose which ones you’re requesting surrogacy for or granting surrogacy, to, right? So then we would still have to grant you guys separate surrogacy if you’re going to manage their npes, and then we would be managing the enrollments under Pecos if you needed their surrogacy to Pecos too, that would have to be included, but it doesn’t share because they have to individually grant surrogacy.
Kimwaters (10:52) Okay. But they can grant two, right?
Naomi Denson (10:55) Yeah.
Staff (10:55) You can grant multiple… so.
Kimwaters (10:59) It’s not a situation where like Monya, you couldn’t see anything, no.
Staff (11:03) It’s just,
Kimwaters (11:03) yeah.
Staff (11:05) We have to do it in addition to them. So they’re going to get hit with two emails from CMS Ina instead of one.
Naomi Denson (11:13) But that’s just.
Kimwaters (11:14) Something we can let them know like in the letter… in the letter. Yeah. But it’s a good call out.
Staff (11:24) Yeah. The other question then was when we term providers, I… know we’re working on the front end of it right now, but I had a provider that we just termed. So it made me think of it, how far in the steps forward does medallion do for termed providers or does that all fall back on us to completely term them out?
Naomi Denson (11:45) Medallion does not terminate with payers. We do new enrollments, revalidations, demographic updates, but we do not handle any terminations. Okay? Except where the rosters are concerned, where delegated rosters are concerned. Once they’re terminated in the platform, they will load onto those rosters as a term. But with direct payer enrollments, we don’t handle those terminations, okay?
Naomi Denson (12:20) Anything else, Monya?
Staff (12:23) Let me write this down first. Okay. And no, in test maintenance?
Kimwaters (12:34) Monya, from an in test standpoint, is there like that? It’s something that we’re checking and just ensuring that it’s aligned?
Staff (12:42) Yes. I mean, that’s part of what Nicole does on onboarding. She pulls the npi puts it in their folder because it’s one of the psvs that’s required. Yep. So let’s… see. Okay. Next item is on the list here. Okay? One of the documents that you have listed is malpractice certificate of insurance. Okay? Part of their onboarding packet currently is that they receive an application for our malpractice insurance, so that Coi would be coming from us, not from the individual providers, right?
Naomi Denson (13:23) So, it’s just a requirement in their profile. So you all can load that to their profile. Once you have the Coi issued with their name on it. Okay?
Staff (13:36) Let’s see supervising physician, collaborative agreements again, that’s part of our onboarding process with that paperwork. So they won’t already currently have that. Yeah.
Naomi Denson (13:47) It’s just asking for specific provider types that require those collaborative agreements that will ask for them to upload it to their profile.
Staff (13:55) Okay. That’s what I’m saying they won’t have it. We have it.
Naomi Denson (13:59) Right? And you can load that we can update.
Kimwaters (14:02) We can update that. Monya. I know we’ve got time this afternoon like we can go through and update that letter. And then Naomi, I think it’s helpful for us to understand. I don’t want to have to tell providers like, yeah, you’re going to get a notification for this, ask, but don’t worry about that one but only worry about these notifications. Like don’t worry about these when it comes to like what they’re being asked for versus maybe what our team is being asked for. Can we just clarify that? Like right now, it sounds like all tasks are coming to admin, like is how we have it set up, but moving forward, like there will be some tasks that can come to us and others that might be appropriate to go to a provider.
Naomi Denson (14:47) Yeah. So the list that Monya is going through right now with that provider packet, those are the requirements and fields in their profiles. So those won’t generate tasks unless you request work from us and it’s missing. So it’s just part of the overall profile completion which they won’t get. I can right now, it is set up to where they would get profile completion reminders. If they have logged in, accepted the invite, but are still missing agreements or attestations. So they’d get there’s. A weekly automated email that goes out and says, hey, you’re still missing these pieces of your profile. It would go to admins and the provider directly. I can turn it off to not go to the provider, but it depends on if you want them to be, you know, reminded if they, a lot of times I see providers, they accept the invite, they log in and they just don’t do anything. So they have assignee agreements and work is just people make requests and it’s just sitting there so that’s just.
Kimwaters (15:44) good. That’s like how we operationalize this, right? So I think it’s good to just talk through how those get generated and for us to know like Nicole especially as you’re working with people and onboarding like, hey, I’ve got these two handled for you. But remember you’re the one that has to sign this kind of thing or whatever. It’ll be good for us to be able to call some of that out and even… like talk about like the order of how quickly we turn some of those things around. So those aren’t on the… task list, you know, for very long… or just let them know, hey, this is going to be on you’re. Going to see this on the task list for two weeks or something like that just to kind of give them an idea. So we need to talk through some of those workflows. But understanding how people get tasks I think is important. Yeah.
Naomi Denson (16:38) The tasks themselves are based off of requests made for that provider. Yes. So I can definitely send over. So we have the automated emails outlined that what admins receive and what providers receive from. Medallion. I also have checklists from our intake team that outlines exactly what they’re looking for in the profile for certain request types. So individual providers versus a group enrollment or, you know, individuals being linked to a group et cetera. So I have a couple of checklists that I can send over that outlines exactly what in their profile they’re looking for. One thing to note is it’s the threshold is 85 percent complete profile and attested. So if you make a request and the provider’s profile is 85 percent complete or more. And they’ve attested, it will move over to our intake team. They’ll review it for anything valid that’s missing from the profile and then task out. Otherwise, it gets pushed forward to our processing pay enrollment team. If it’s under 85 percent complete, it sits in requested until more of the profile’s completed for it to automatically switch over to our intake workflow. Okay?
Kimwaters (18:02) Got it. Yeah, if you can send those over, that would be helpful yeah.
Staff (18:06) That would make that would be a big help because we’ve got some providers that Nicole basically has to babysit.
Kimwaters (18:14) she hasn’t come off mute yet. She’s just smiling. So.
Naomi Denson (18:20) All… yeah, I’ll get this sent over to you. That’s great for the relevant task for intake. Awesome. Anything else from you Monya?
Staff (18:34) No, that was pretty well. My concerns right there. I’m like sitting here reading through this. I’m thinking, okay, they don’t have this. They don’t have this because it all comes from us but they have forms. They have to fill out and get back to us to.
Kimwaters (18:46) Get this, right? Yeah. Okay. And.
Naomi Denson (18:51) then the data import template, we received the first five tabs. I’ve sent those over to Adalee to review the data. If she has any questions or feedback for you that would prevent us from importing, she will let me know or let you know directly and we’ll work through any corrections that need made, but we will work to get those first five tabs loaded.
Kimwaters (19:15) And we’re just waiting on the enrollment tabs, right? Yeah. So that’s what you’re waiting on. Okay? And that I’m just waiting to see if that’s going to come from. You know, I’ll have Felipe pull that or directly from the athena team. But either way, that should be a quick, a pretty quick turnaround and.
Naomi Denson (19:34) then, will you be completing the external accounts tab for their caqh logins?
Kimwaters (19:38) That’s completed?
Naomi Denson (19:40) That is completed. Okay?
Kimwaters (19:41) You may, you may be missing a couple of emails and I have to check it, but it’s if it’s not complete, it’s, very close so I can check a couple emails. Yeah.
Adalee Arreola (19:53) Naomi, are you able to quickly share the data import template? I do have a question on it.
Adalee Arreola (20:06) Okay, great. Can you go to group profiles?
Adalee Arreola (20:13) How are we going to be handling, the npis for these groups? No?
Naomi Denson (20:18) No npis. We’re built. We’re only using the practice location, npis. Okay. All right. And.
Adalee Arreola (20:25) then I did notice there, yep the external accounts, it looks like we are missing some emails… but just feel free to, if you can give that a second pass and then feel free to just send me a message when that’s.
Kimwaters (20:41) complete.
Staff (20:42) okay. I thought I had went through and removed like dr pass. Well, I did off of the provider tab, dr, pastor, he retired. So he’s out.
Naomi Denson (21:00) Yeah. Removing them from the provider’s tab. We’ll remove them from here. Yeah.
Staff (21:03) I didn’t even realize that I can go back to that and dr price, hers is on the provider tab.
Kimwaters (21:13) Yeah, I’m sure they’re all listed there. We can go.
Staff (21:18) I didn’t realize that this tab was in processor. I would have flipped to it too when I was doing all of those.
Naomi Denson (21:25) Okay. Yeah, we’ll just get this one.
Kimwaters (21:28) We’re almost done that we should be able to have to you this afternoon.
Naomi Denson (21:31) Okay, perfect. Yeah. And then we’ll include that with our bundle of imports that we have now. And then it would just be the enrollments… imports. And then are we going to load recredentialing dates for providers that are already credentialed for them to trigger for recredentialing?
Kimwaters (21:52) Monya, I think you said most of them would have been scheduled for may?
Staff (21:58) Yeah, most of them have been scheduled for may. Sorry, we can get that to you. There’s a few, I mean, the newer providers of course, aren’t may, but the biggest part of them were may.
Monya Hunter (22:09) Yeah. It’s in the extract that we can pull from Andro, so it’ll have the recredentialing date on it. Okay for everyone who’s currently active, okay?
Naomi Denson (22:22) Yeah. So we can load those.
Kimwaters (22:25) Would that have been much different than the last time you pulled it? Monya, it was just a couple weeks ago.
Monya Hunter (22:32) Just if there was any recently delegated providers?
Staff (22:37) There’d only be like two more.
Kimwaters (22:39) Two more. Yeah… if it’s easy to, if it’s easy to run, if you want to want.
Monya Hunter (22:51) Jamie to run it again?
Kimwaters (22:52) That one?
Kimwaters (22:58) All right.
Kimwaters (23:03) And then we have a couple of providers coming up. I think that are going to be, that are new providers say in the next two to three weeks? Is it possible to like if we’ve got a couple of them that are open to trying this? Do we think like for new providers, we’ll be ready and ready. I know they’d mentioned in the sales process, they had mentioned like new providers could probably be onboarded earlier than like the actual like launch date, I don’t want to push it. I want it to be right?
Naomi Denson (23:35) Yeah, but.
Kimwaters (23:37) We, if just your thoughts on two?
Naomi Denson (23:40) To three weeks might be a little close with us having to still do the payor scoping payor mapping and make sure all of your processes are in place for the payor enrollment. And then for credentialing, we have some verifications that are non standard to ncqa that we talked about last week like death master and the state specific stuff and the collaborative agreements that we have to have our engineering team build, which sometimes can take up to two weeks. So I wouldn’t… I mean, we can try, we can target it and see if we get there. But I wouldn’t totally rely on. I.
Kimwaters (24:18) Don’t have actual hard start dates yet. So just, and there will be somebody new that we can try this with on these additional psvs, this is for the monyas. Are these things that we always checked just because we checked them or are they part of our delegated agreements part?
Staff (24:37) Of our delegated agreements, the?
Kimwaters (24:39) Death master and the okay.
Monya Hunter (24:42) Yes.
Staff (24:43) Requirements yep?
Monya Hunter (24:48) And some of them, you have to, you have to check monthly ongoing as well. It’s in the policy. What’s supposed to be checked when? Yeah. Okay.
Naomi Denson (25:05) Yeah. And then one other thing, I got the legacy credentialing files. I’ve sent those over to our credentialing team for the provider files. So they’re reviewing those as well. We’ll let you know if we have any other questions or clarifications needed for the sop internally on our end. And then I did just want to talk about the, oh, I went too far down the credentialing committee bill. So, you have this statement in your credentialing policies and procedures, non clinical committee members will not participate in credentialing decisions. And then only physician members can vote on physician files. So in medallion, I just wanted to kind of get an idea of how we should be building the committees within medallion. I saw these two files looked like they were two different buckets clean and then they go for leveling review that are reviewed by the chief medical officer. So who should be the, because you’re still going to have your internal committee meetings. So who should be the designated committee member or members that will come back and vote in platform to close out the file and capture the credentialing dates after those meetings. So how?
Monya Hunter (26:19) We’ve been doing it, is it gets approved during the meeting by the clinicians based on and that’s based on the ncqa guidelines. But then Monya york, someone from the credentialing team could go put the dates in the system because we had the meeting minutes that supported the decision.
Naomi Denson (26:39) Okay. Does it have? Yeah. And the reason I ask this is because it says only the physician members can vote on the physician files. So typically, we would need it written into your policy that states an administrator can close out and capture like the voting process. So I can build it with Monya or someone as the primary voting member, and then have a backup in case you were out of office. Typically, what I’ve seen with other customers is they have their chief medical officer or medical director as the primary voter for clean files. If you, I don’t know if you take all of your files to committee no matter what, or only those that need review. So typically, we could assign the committee, chief medical officer as a committee member in medallion to vote, and you guys would assign the clean files to him only. And then he could review and vote directly in platform. And then other customers, they go to their meetings, they capture the votes, the meeting minutes, and then designated administrator to come back and vote on all of those needs attention files that have to be reviewed with the final outcome.
Monya Hunter (27:45) Today, if you read our policies, the chief medical officer does not review any clean or leveling review files, they’re available for them to look at.
Monya Hunter (28:02) As a committee, he’s ones that don’t meet clean and leveling review. Is that still correct Monya york? Correct? We.
Staff (28:11) Didn’t change any of that?
Naomi Denson (28:12) Yeah.
Staff (28:14) When we’re talking in the policy and procedures, there, when we’re talking voting, we’re talking about, they’re in the committee and it’s one that they’re having to review in committee that they vote on. They don’t vote on any of the rest of them. Okay?
Naomi Denson (28:30) Yeah. Is this the correct one that I’m looking at here? This is still correct.
Monya Hunter (28:39) Yes.
Monya Hunter (28:45) That should be. Is that the plan, it may be in the policy?
Kimwaters (28:48) That’s the plan.
Monya Hunter (28:52) It’s been a minute since I’ve looked at those.
Naomi Denson (28:57) Okay. Yeah. You guys tell me how you want it built and I can build it on the back end. I just noticed that on the user list that you guys sent me, there were several providers on there… that I think you wanted the admin and provider access. Are those the committee members? Or do they have another role that requires them to have the admin access? Those are.
Kimwaters (29:21) just the committee members. Okay?
Naomi Denson (29:23) So, we don’t need to have them as provider and admin unless they’re voting in the platform, which we wouldn’t we don’t typically see where the committees are being built with all the providers on one committee, because then every person has to vote before the file will close out. And if somebody’s out or isn’t eligible to vote on that file, then we wouldn’t want that. So we typically just designate one person per committee and then have backups as needed. So, if you could let me know, yes.
Monya Hunter (29:53) Those details about the clean and leveling and committee files is in the credentialing and recredentialing guidelines on page six where it talks about what we do with the clean files versus leveling review and committee files.
Naomi Denson (30:12) My Google folder is and.
Monya Hunter (30:15) How we’ve been doing it. So the agenda goes out for that meeting and there is a link in it, so the chief medical officer, everyone can review the files. I don’t know, dr Han may be looking at all of them, I don’t know. But so it’s embedded that embedded link in the agenda so that it’s been given to them to review. And they get that before the meeting. But the only ones we discuss in the meeting are the committee files.
Kimwaters (30:43) The other ones are just kind of like standing votes because they’re clean. So, yes, approve.
Monya Hunter (30:48) Them. Yeah, there’s clean. So, what are you going to talk about, right?
Kimwaters (30:51) Yeah, there’s nothing to talk about. It’s just like, yes, you’re approving you’re. Approving these, but to have a date on them, I guess is the question like if it’s a clean file, is the date that it’s like approved? The date of that committee meeting? Okay? Yes, it’s like it’s almost like a standing, just like any, yes, we approve and like we approve all clean files kind of thing. Yeah.
Monya Hunter (31:15) Because the folks helping us run the meetings would say, you know, someone would raise, hey, I say these all be approved. And there was a second with the second bit and that all gets captured in the meeting? Yeah.
Naomi Denson (31:28) And I see cmf preclusion listed here. I don’t think we had that one on the list when we talked last week. Is that one that you guys expect to be in the files? I?
Monya Hunter (31:39) Don’t Monya, york, we couldn’t get that. Could we?
Staff (31:43) That was, no, we couldn’t get that or the deathmaster. It had to come from the… cbo, the preclusion list. Yes, they do that. Still, it’s in if you look at that. Andros, is it in?
Monya Hunter (31:57) Andros, yeah, because.
Staff (32:03) The medicare opt out and the preclusion list is actually through Sam or oig.
Naomi Denson (32:10) Okay. So, it’s not from the CMS preclusion site?
Monya Hunter (32:16) It’s actually, we have medicare opt out, New Jersey debarment death master, Sam, omig, oig, and PDB are the monthly monitorings on our screen. Okay? So I don’t see CMS preclusion. I remember something that we couldn’t get access to that for whatever reason. Yeah. And I.
Naomi Denson (32:39) See that a lot with customers because you have to have the list, you have to have access to the list or it has to be a requirement. And with a payer, specifically, medicare and medicaid, that agreement that gets you access to that. Yeah.
Monya Hunter (32:53) And I think when we built these out, you know, it was a work in process and we’ve been able to get credentials and no one’s asked for that. So it probably should be updated on that policy and removed.
Naomi Denson (33:05) Yeah.
Staff (33:06) Because if I remember, right, centene, came back and said that they had access and so they didn’t need us to have it.
Monya Hunter (33:11) Didn’t need it. Yeah.
Naomi Denson (33:13) Fair enough. All right. So, yeah, we’ll just decide one… you know, let me know the name of whomever should have their own committee and what structure and committees you want them assigned to. I can name them whatever you want. You can have as many committees as you want. So we can get those built. And then for the other providers on the committee that aren’t going to be designated voters or in the committee. Do we still want them to have credentialing administrator access? So they can still view files… they.
Staff (33:52) Need to be able to view.
Kimwaters (33:53) Files. Yeah. Okay. But the providers that are on that list are the committee members, if that’s helpful, Naomi. Okay?
Naomi Denson (34:03) So, those are all the committee members. So once we get the providers loaded, I can update their access to provider and admin, and then they would get… the credentialing administrator access so they can see the files. The only thing is with the credentialing administrator access?
Kimwaters (34:20) We haven’t told all of them to be expecting emails yet. So, is that yeah?
Naomi Denson (34:25) Yeah. And that was one thing I was going to also say is when I update that user role, they’re going to get their email automatically. So I’ll wait until you guys say, okay, let’s update their access. Yeah. Well, I won’t do it without talking to you. Yeah… I don’t they all know we’re.
Staff (34:42) changing platforms. They just don’t yeah.
Naomi Denson (34:45) They would.
Kimwaters (34:46) Probably be fine actually. But still, and then Monya is going to be out next week. So, on this payr scoping template, we’ve got a couple of internal conversations to get this settled today, but can we use the time on Wednesday even if we need to like extend it or if there’s other time I don’t want to like have a delay in anything if we need or even like Friday, like whatever time we need to review that together. Can we, can we set that up for this week?
Naomi Denson (35:22) Yeah. If you guys are confident that you can have the sheet completed and filled out, we can definitely utilize our time Wednesday.
Staff (35:32) And these are for ones that are just outside the normal routine, right? Well.
Naomi Denson (35:36) Typically, we want all of your payers on here so that we can go through each one. So it would be all of your payers… on this list… because we’re also going to use this for the payer mapping. So where we’re mapping your standard payer names to the medallion payer names to, for the imports. Okay? Does that make sense?
Kimwaters (36:02) Priority for medallion to support? Like what does that even?
Naomi Denson (36:05) Mean? Like what’s your priority level for this payer? Like is this a high priority? You know, revenue for you? Is this a lower priority payer? You don’t see it that often, but you still utilize or see patients with it. It’s not very common. It’s just your priority of importance for that work on that payer? Okay? And for us current?
Kimwaters (36:30) Group enrollment. Is that just going to be applicable to like commercial payers? Yeah.
Naomi Denson (36:36) Just, do you have a current agreement in place with that payer? So some customers will list payers that they want or plan to get in network with, but are not yet? Okay? Got it. And then, are they roster eligible? If they are the roster template, you don’t need to share the delegated rosters here. We already have those and then non standard enrollment processes, client notes, if you have direct contacts at the payers that we should be aware of or any different, like I mentioned in my email earlier, any rules or nuances that we should be aware of as it pertains to billing or npis or submissions, we would have all of that outlined. Okay?
Kimwaters (37:20) And is it just the first tab on this document? Yes, you?
Naomi Denson (37:23) Only do the first tab here?
Kimwaters (37:25) Yeah, I was looking for the rest of it, so.
Naomi Denson (37:26) Yeah, Jason will work on the others. This is if we need to build specific project plans for any of the payers and embed it to the system so that our teams are directed to your processes instead of our standard processes.
Kimwaters (37:39) Okay. I doubt 30 minutes is gonna be enough to go.
Naomi Denson (37:42) Through this. Let me look at calendar. Yeah.
Kimwaters (37:47) If we maybe get that on the books, then I think we can.
Staff (37:52) Because when we’re like talking medicare, we’re talking for the providers, it’s medicare B, but for the rhc, once they become rhc clinics, it’s medicare a, there’s multiple steps to get to the medicare a. So I think right now just focus on the provider portion… of it, yes.
Naomi Denson (38:12) I can add 30 minutes to the front or the back of our call for Wednesday. So do we want to start 30 minutes earlier or go 30 minutes later?
Kimwaters (38:22) I’m good for either Monya, what works for you?
Naomi Denson (38:26) I’m good for either. Okay?
Kimwaters (38:29) You just start at one?
Naomi Denson (38:31) Jason, do you have a preference?
Jason Zednick (38:36) Your.
Naomi Denson (38:37) calendar’s open both directions, but you have a meeting right after?
Jason Zednick (38:42) Or before I think, but not strongly. Okay.
Naomi Denson (38:49) All right. I will get that.
Jason Zednick (38:54) Well, Naomi does that. Sorry not to jump backwards too far but just with regards to the committee and how we set the committee up in medallion, my personal recommendation. Not everyone does this way. This is just my preference. So just take it under consideration. Is that you… in medallion, you have sort of designated admins to record the committee approvals versus having the individual committee members record the approvals. And my reasoning there is that your meeting minutes are the official record of the approval that’s what would get audited. And if you have it so that your members have to vote in medallion instead of having one person responsible for going in and recording the approval and making sure it’s done. You now have five or seven depending on how many committee members you have, which creates way more failure points in the process people to chase down. Like, hey, can you please click it? Please, click it. And I just think it’s smoother if you have one or two people that are responsible, one person can go in and approve it and if they can’t they can just switch the ownership over and someone else can? I just think it streamlines things. So I tend to recommend that way instead.
Staff (40:23) Well, that’s how we currently work.
Jason Zednick (40:27) That’s perfect. Then. Yeah.
Naomi Denson (40:29) Perfect. Okay. I know we went over a little bit here. I’ve adjusted the time meeting for Wednesday to allow for an hour for the payr process scoping call. If for any reason, you guys aren’t able to finish the sheet before, then let me know and we can find another time later in the week before Monya goes out. Okay? Yep.
Kimwaters (40:48) And we may want to even like find a hold for another time anyway, if there’s like another slot to hold for because I know we’ve got to do like payr mapping as well. Yeah.
Naomi Denson (41:01) So, the payr mapping, we run it through a tool on our end using the payr names that you sent us. And then we or Jason will review that with our PE team and make sure that everything’s aligned. And then we’ll send it back to you with our map names. And then you get there’s like a checkbox that you guys will go through and approve or leave feedback or comments on that so that’s not typically a call need. It’s more of an exercise that we’ll work through.
Kimwaters (41:25) Okay. Sounds good. All right. I.
Naomi Denson (41:28) hope you guys have a great next couple of days and we’ll see you on Wednesday all.
Kimwaters (41:32) Right. See you guys.
Naomi Denson (41:32) Thank you.