Transcript
Catherine Tien (00:00) hey, Leigh. Hi.
Leigh Howle (00:01) Catherine?
Catherine Tien (00:03) How’s your going so far? Yeah.
Leigh Howle (00:07) Good. Yeah, I guess what about you?
Catherine Tien (00:12) Yeah, pretty good. Can’t complain?
Leigh Howle (00:15) Yeah, yeah. I was looking at some cred files and, you know, I sent the list over today and I noticed there were some other providers that weren’t quite moving. They were, you know, in that pause state and I was like what’s going on? And so, apparently… and you may have already seen this, but there on Friday, there is an ongoing monitoring bug issue that our engineering team is working on.
Catherine Tien (00:50) Okay.
Leigh Howle (00:51) And it is affecting… dmf and ofac results. Okay. So, but the, I think this is 13 providers that I sent. Yeah, 12, 12 providers here. These are fine. So, these listed here are good to go. Okay. And as soon as the bug is resolved, the remaining providers will be prioritized for the committee meeting on Friday. So, I know it’s not ideal to lead off the meeting with this, but I was just like, I just recently learned about it and I was like, no.
Catherine Tien (01:29) No, thank you. Yeah, thank you for that. I noticed that. I just didn’t see as many people ready on Friday as what I thought, but I didn’t have time to really investigate that. Why, and so, thank you for already having done that and letting me know.
Leigh Howle (01:45) Yes, absolutely. And.
Catherine Tien (01:48) So, you said like basically the ofac and dmf results are just like stuck kind.
Leigh Howle (01:55) Of yes, right? They’re not currently reflecting in medallion’s platform?
Catherine Tien (02:01) Okay. Thank you. And you said these new people you sent today, like why does it not affect them?
Leigh Howle (02:12) Not sure on the stage of development of where their cred app was. My thinking is that they were, their verification was already in their cred files. So there was no issue with them with ogm.
Catherine Tien (02:34) Okay.
Catherine Tien (02:41) I’m also just thinking about?
Catherine Tien (02:48) Like I’m trying to think what my actual question is because… I thought with our renewal, our ogm… package does not even include ofac and dmf?
Leigh Howle (03:06) Oh, that’s right? It didn’t so, let… me, what did?
Leigh Howle (03:19) Okay. Let me get into this message and go back a little further. These are task titles that the team is using. So that probably explains that… where I got the dmf and ofac.
Leigh Howle (03:51) Let me ask.
Leigh Howle (04:15) You all do have medicare. Do you have medicare exclusions or medicaid? No, I.
Catherine Tien (04:21) think we have like medicare opt out and medicaid? Exclusions?
Leigh Howle (04:25) Okay.
Leigh Howle (04:45) Yeah. I looked at cherry Lynn lindgren and her npdb does show complete clean file sourced on 412. And.
Leigh Howle (05:01) that’s all I see.
Leigh Howle (05:11) Medicare opt out was completed 411 state disclosure answers, 412… npi, verified on 410. Okay. He’s responding back. My question was will doesn’t have dmf and ofac, is it all? Ogm? Will does have medicare opt out and medicaid exclusions. So we’ll see what the answer is on that question.
Catherine Tien (05:45) Yeah. I’m… seeing like just looking at completed files, it looks like ofac happens. And… let me see deathmaster like seems… like even though we technically don’t need it to be happening, it is still part of the credentialing process. And so it is a blocker when it doesn’t get completed.
Leigh Howle (06:18) Which provider did you check out?
Catherine Tien (06:20) I’m just like looking at, I’m just picking somebody who was credentialed like in April, for example, Teresa, Walsh, Brittany.
Leigh Howle (06:32) Brown. I see several on here. Let me look at Brittany’s and see what her shows.
Leigh Howle (06:49) Yes, it does have it in there. So, when I look at Brittany brown, she does have the green check by deathmaster… ofac.
Leigh Howle (07:16) Yeah. I recall, there was a conversation about not doing the monthly report with the monitoring on this for deathmaster. And.
Leigh Howle (07:36) I’m going to.
Catherine Tien (07:38) Just like copy and paste something. I’m going to put this into our.
Catherine Tien (07:52) So this image is just, ooh, that’s not where I wanted it. This image is just what I’m going off of because when we were talking about the renewal, we were told that there was like a couple of different tiers of monitoring. And before our renewal, we were at like the most, you know, intense and expensive tier. And so I thought that we downgraded a little bit to be just at that monitoring tier that meets ncqa requirements. And my understanding was that ofac and dmf was like above and beyond what ncqa needed. So… I don’t know if that’s still true or not. But that seems to be what we talked about during the renewal and what this chart is saying.
Leigh Howle (08:47) Okay. For some reason, let me, I didn’t see it in the chat. Are you sharing your screen? I?
Catherine Tien (08:56) Put it in our agenda? Oh, sorry. Sorry, I wasn’t clear on where I dropped the, that’s okay?
Leigh Howle (09:04) Okay. Got it. Yes. All right. So what I’m thinking is there was a contract change. It didn’t get turned off in our settings. So this could actually be a good thing. So let me get together with Molly and find out what needs to happen to update the settings. And then I’ll get in touch with the credentialing team and let them know that this doesn’t it’s not required in the files and find out if they can just go ahead and start working on these tomorrow.
Catherine Tien (09:41) Okay. That makes sense. Thank you.
Leigh Howle (09:45) Thank you. Yeah.
Catherine Tien (09:47) And this is like related, but I know you had helped us like push along this ticket that’s related to how we wanted the profiles to only have service based requirements. So basically only cred requirements. But then that caused like a whole issue of how that disclosure question tab disappeared for all of our admins. So was there anything else from epd about that?
Leigh Howle (10:22) Let me circle back on the ticket.
Leigh Howle (11:15) It shows done. I checked this last week… delivery date was April tenth. This is complete disclosure questions marked visible plus required for all professions. Okay. Let me test this. So this is good.
Leigh Howle (11:44) So what I can do if you don’t mind, I can go ahead and go in and change the service request service requirements now to make it on and engineering did go ahead and update the disclosure questions to make it visible even if the service requirements are turned.
Catherine Tien (12:07) off. Okay. Yeah. Let’s see. Let’s cross our fingers and see what happens.
Leigh Howle (12:50) Let me go into profile. There’s. Two places I can go to update it. It’s either in the profile or the org and I always get them mixed up. I was in the profile. Let me go to the org.
Leigh Howle (13:47) Okay. Service based profile requirements here. It is. I’m going to turn this on, check to turn on request based profile, requirements, provider profile, required fields will be set based on what requests have been made for the provider save. Okay, that is done. Let me refresh and go into a provider profile.
Catherine Tien (14:22) Ooh. Okay. So far, the one I picked seems good.
Leigh Howle (14:29) That is good.
Catherine Tien (14:31) But let me, so his percentage went way up which we would expect. But now, I’m going to see if I can still see everyone’s stuff who like isn’t ready basically.
Leigh Howle (14:46) That’s a good idea. Okay. I see Ravindra Gupta in ready. Okay?
Catherine Tien (14:52) It looks like the disclosure tab is missing again, it.
Leigh Howle (14:57) Is missing for? Ravindra? Okay. Let me, let me go back and change it… and then I will send… the message in the ticket and let them know that this is not resolved quite yet.
Catherine Tien (15:20) Should we then undo the service based requirements that you just did? Because, yeah.
Leigh Howle (15:29) Yeah, definitely. I just unchecked it. So it’s back to the way it was originally. Okay. Let me refresh dr Gupta. Okay. Yeah, they’re there disclosure questions are back. Okay?
Leigh Howle (16:36) Okay. And I actually have a ticket number for this one, two eight five five. Let me add this to our agenda.
Catherine Tien (16:44) Okay.
Catherine Tien (16:49) I put a little blurb, so, yeah, cool. Thank you.
Leigh Howle (17:25) I’m going to link it just for me so I can pretty quickly hop into it. But, okay, that is good.
Leigh Howle (17:37) Am I on the email with the contract change with Molly? Yeah.
Catherine Tien (17:42) Let me see. I.
Leigh Howle (17:45) Can also, I’m going to go ahead and message her right now and just find out if she can give me a little more information on what needs to be updated in the settings?
Catherine Tien (17:55) It’s a really long chain from November that talks about all kinds of things. So, it’s probably more straightforward if you just ask her questions, a specific question, cause there’s like there’s a lot of like you’d have to come through like, you know?
Catherine Tien (18:21) 28. It’s an email chain with 28 back and forth. Oh.
Leigh Howle (18:25) My goodness.
Leigh Howle (18:41) So, ofac and dmf need to be off, right? Is that what you?
Catherine Tien (18:47) All that’s my understanding just because medallion said they’re not necessary for ncqa monitoring. OK, so, I’m not claiming that because I personally know it’s just, it’s based on the SKU description that medallion told us.
Leigh Howle (19:07) OK.
Leigh Howle (19:59) OK. All right. I just sent her a message as soon as I can get a little more clarity on that. I will send you an email and loop Molly in and let you know, OK?
Catherine Tien (20:10) Thank you. That sounds good.
Leigh Howle (20:12) Awesome. Did you have anything else to go over? I?
Catherine Tien (20:20) Just have one provider specific question which is Blessy Sam, because when I’m looking at the credentialing requests, they completed the app on April first and it does not look like the dmf or ofac thing is holding them up. So, I’m wondering if you can see anything on your end because I don’t see any tasks either for Blessy Sam.
Leigh Howle (20:51) OK. Let me pull up her cred file and credentialing.
Leigh Howle (21:00) Yeah, it says app completed April first.
Leigh Howle (21:10) But this also has… so there’s like an internal… medallion task… and it’s the same thing. So, it does say the… bug issue.
Catherine Tien (21:27) Is what?
Leigh Howle (21:30) Is holding up this one?
Catherine Tien (21:36) OK. So it’s I guess, does it say what item?
Leigh Howle (21:41) It’s the same one. Yeah, it says for deathmaster file and ofac, OK?
Catherine Tien (21:49) Because it has a green checkmark for those. So that’s weird.
Leigh Howle (21:53) That’s very weird.
Leigh Howle (22:01) Are they listed? And let me go into her profile and see if there’s anything in the, you know, the verification will have the screenshot, and then the website of what was verified,
Leigh Howle (22:29) I don’t see it. I see mpdb and… the medicaid exclusions, but I don’t see dmf there’s oig, and Sam.
Leigh Howle (22:46) Do you see it? Do you see dmf?
Catherine Tien (22:48) Yeah, I’m also going to open it.
Catherine Tien (23:22) Yeah, I mean, it’s not on my screen. Are you looking under verifications? Yep. Because I don’t see it on just using Ravindra Gupta, the person who was in ready. I don’t see it any of those in his verifications either?
Leigh Howle (23:55) Oh, yeah. It’s not there. It’s.
Catherine Tien (23:58) almost like this verifications page reflects our SKU where there is no dmf. There is no ofac, but then in terms of the credentialing file process, it’s like medallion’s still doing those things, but it doesn’t land in our verifications page.
Leigh Howle (24:19) Oh, yes, it is not there, but it does show in that credentialing like it’s part of the workflow. Yeah, yeah, it’s definitely in this module. Maybe that’s what the bug is, that they are not talking to each other. Yeah.
Catherine Tien (24:42) So, I think the first thing is what you’re already doing, which is getting confirmation if we’re supposed to have ofac or dmf at all? And then the question is like, is there something that actually medallion is doing unnecessary work, you know, because those items are part of the cred team’s workflow right now.
Catherine Tien (25:11) Right.
Leigh Howle (25:13) Okay. But.
Catherine Tien (25:15) Yeah, for Blessy, Sam, and for, excuse me, David, Nicholas, Dahl, those are the two people who are under requests right now where I can’t really tell why they’re not in the ready stage yet.
Leigh Howle (25:35) Who were those two providers?
Catherine Tien (25:38) Yeah, I’m gonna let me drop their names in the document. So I put David Nicholas Dahl. And then the… one I said before that was Blessy Sam, where.
Leigh Howle (26:00) I’m going to put a link right into her credentialing file.
Catherine Tien (26:05) Yeah. Like everyone else, I can see how you know, ofac or dmf either one or both. Are, you know, missing and blocking, but with Blessy Sam and David Nicholas Dahl, like I can’t actually tell why they’re blocked. Maybe David Nicholas Dahl is just, he just, did you just do that? I think he just became ready? No, he disappeared somewhere where’d he go? I literally watched him drop off the screen. Oh, no, he’s still there? Okay. Yeah. Like if you look at his psvs, they seem like they’re all done. So.
Leigh Howle (27:00) Okay. Let me pull up his file. I’m it has a, the orange triangle with disclosure answers licenses mpdb but it also has ofac and deathmaster with the check marks.
Catherine Tien (27:16) You know what? For him? I see he has a task… they wanted. They wanted more supporting documents.
Leigh Howle (27:25) Oh, right. I see that now. Okay?
Catherine Tien (27:28) So, I do understand him then never mind. But, I think I checked that for Blessy, and I don’t think that’s what’s happening with, right?
Leigh Howle (27:38) I checked her earlier today and I noticed the same thing that the only blocker… I guess, you know, that is holding up hers is, it does say like an internal task with the sanctions bug issue for dmf and ofac, okay?
Catherine Tien (27:57) Okay. Well… thanks. It seems like that’s like the biggest thing to see if that doesn’t need to be a part of our platform’s workflow at all. Then that would just solve a lot of this stuff. So, thanks for looking into it.
Leigh Howle (28:17) Absolutely. It definitely would. Yeah, for sure. So, Molly’s already reaching out to me and so we will think and try to figure out, you know, we’ll get it figured out for sure. We’ll turn it off wherever it needs to be turned off or make sure that apd connects… the credentialing module to the provider verification module so that they match.
Catherine Tien (28:43) Okay. Yeah, that sounds good. Okay?
Leigh Howle (28:47) And I’ll definitely send you an email and keep you updated on it.
Catherine Tien (28:51) Thank you. Oh.
Leigh Howle (28:53) She said they are turned off. So ofac and dme are turned off. Okay? So, maybe this is the bug?
Leigh Howle (29:19) Okay. Yeah. I bet that’s what it is… so the team can’t move forward with it because it’s not removed out of the credentialing module even though it shouldn’t be there. Yeah… so they can’t process it until it’s been removed.
Leigh Howle (29:45) Okay. All right. Well, this was productive. I feel like we did some critical thinking, yeah.
Catherine Tien (29:51) For sure. I like our, I don’t like these problems, but I appreciate working with you to, you know, investigate and resolve. So I enjoy that part of it.
Leigh Howle (30:02) Yeah, same, I do too. We work really good when it comes to resolving issues. So… all right. Well, I, thank you so much for your time. And as soon as I have some more information, I’ll send you an email and let you know.
Catherine Tien (30:16) Okay. Yeah, that sounds great. Thank you, Lee all.
Leigh Howle (30:19) Right. Sounds good. Thank you, Catherine. Have a good evening. You too. All right. Bye?