Transcript
Deanna (00:00) hello? Hi.
Leigh Howle (00:02) Deanna.
Leigh Howle (00:07) Hi, Kim. Hi.
Leigh Howle (00:24) Hi, Marna. Hey, Lee. How are you? I’m doing good. Thank you. I’ll go ahead and turn my camera off. So you all don’t have to stare at me. So, I think this should be it. Should we go ahead and get started, Deanna?
Deanna (00:43) Yeah, let’s go.
Leigh Howle (00:45) Okay. All right. So I will go ahead and share my screen. I didn’t have anything on the agenda today specifically. Did you all have anything that you wanted me to add on to the agenda or to discuss?
Deanna (01:01) I’m good. I was just circling back to the empire thing and where we are with that from New Jersey.
Leigh Howle (01:07) Yes, I did check on the payr directory and I noticed it still has not been added. Let me reach out to Brenda. I think Brenda was Brenda Ruby. She was the one leading the charge on this one and was reaching out to your rep to confirm that last time.
Leigh Howle (01:55) Okay. I will send you an email by end of day today, Vienna on this one?
Deanna (02:00) I appreciate it. Thank you.
Leigh Howle (02:14) Okay. And on the issue tracker, there isn’t anything specifically that I had that was pending from the ent side?
Deanna (02:27) Where are we with dr poulos? Kim had found out that I think it was Kim or maybe it was Marna or Kim was off regardless that we had asked for him to be credentialed last year, and the task was closed because your team said he was participating, which he wasn’t so we’ve gone an entire year without him being participating. Yeah.
Leigh Howle (02:48) So, I did reopen the line, marked it a priority. It is in queue for resubmission by end of day. This was… this should have been done. Let me reach out to Olivia and ask her if she can give me a status on this one?
Leigh Howle (03:35) Okay. I’ll include this one in my email, Deanna, to let you know. This… one should be actioned and resubmitted by end of day.
Deanna (03:49) Okay. I appreciate it. Thank.
Leigh Howle (03:50) You.
Leigh Howle (04:02) the only one I noticed on here that was pending ent, was… this was in a task for Christina Yu with blue cross blue shield. I believe this has been resolved where the ptan was not listed in ceqh. And so the medicare line of business wasn’t getting pulled into avality. The team tried to manually type the medicare ptan into the avality application and it wouldn’t accept it. So, I just wanted to circle back on this one.
Deanna (04:37) I don’t know anything about it. I’d have to go into her caqh and look. Okay? Is.
Kim Martin (04:44) this for horizon or regular blue?
Leigh Howle (04:49) Cross blue shield? I think it is. Yeah, I think it is horizon. No, it’s regular. Okay?
Deanna (05:04) Well, medicaid, is that horizon you’re talking?
Kim Martin (05:08) About, no, she said regular blue cross blue shield. So, when you guys are submitting for blue cross blue shield, are you guys submitting via the roster or are you submitting an online application on avility for these providers? Because I feel like there’s some kind of discrepancy as far as how submission is being handled when we submit for blue cross blue shield, we use a roster, but it seems you guys are using like a portal to submit applications. We can’t see what you guys are submitting at all like via that portal. So we can’t even go in and tell you where you need to update or fix something. So, I think that there needs to be some clarification as to how the submission is being handled.
Leigh Howle (05:47) Yeah. So in blue cross blue shield, it would be submitted in availity under payr spaces. I think there’s a little background noise.
Deanna (06:00) Sorry, it’s the radio in the background, but our workflow… says to use a roster and that’s the way we’ve always used it for a large group. So they’re not following what we instructed to them. And now we’re having those lines of business not being added correctly?
Leigh Howle (06:17) Okay. And that’s for New York, correct? It?
Kim Martin (06:21) Extends into New Jersey as well, which that was another issue with that not being available to submit for our New Jersey providers also. But yes, correct.
Deanna (06:30) Okay. I’ll.
Leigh Howle (06:31) circle back with Olivia on this one and get some more clarification on it. So let me pull… up the project plan and just kind of double check to make sure it matches what the process was sent over. I think when Jennifer Michael was doing it.
Leigh Howle (07:10) It’s loading. Sorry, it’s taking a little minute… okay?
Leigh Howle (07:37) Okay. It looks like for.
Leigh Howle (07:53) Well, it’s still not coming in. Okay. There we go. That’s better. So, for New York and New Jersey, it does have the same process for application submission… and for new providers, it does have on a roster?
Leigh Howle (08:12) It says generate the pdm roster from availability and save in the monthly roster folder. Yeah.
Kim Martin (08:22) It’s supposed to be a roster submission. So I’m not sure how we started doing an availability submission like via an online application, but it is creating issues because again, we can’t see what you guys are submitting so we can’t even kind of like try to explain to you or guide you in a direction to let you know what information is missing because we can’t see the submission.
Leigh Howle (08:44) Yeah, it’s listed right here. Let me, so in the availability application for Christina, Yu, I know that in.
Kim Martin (08:55) And.
Leigh Howle (08:56) it’s by state. You know, it just depends on the state but you can see here it is submitted under pay or spaces in availability. Some states do accept this as a new enrollment application. So just to clarify new enrollment and demographic updates should be submitted on that roster automation and uploaded into availability in the pdm module, correct? Okay. Yeah, I’ll make sure that they go back and resubmit this one. And then they… would be able to manually add that medicare ptan. So that wouldn’t be an issue to add that line of business. That makes sense, right? Because.
Kim Martin (09:37) Yeah, correct. There’s a column for that on the application that, and medicaid id number. So, yeah.
Leigh Howle (09:46) Okay. And so… and then blue cross blue shield does credential new providers with that availability roster application?
Deanna (09:59) They have to date.
Leigh Howle (10:02) Okay. That’s good. Yeah, I sat in when they first migrated to that roster automation, I sat in on a training and there were some questions asked on new enrollments and at the time, they had said not to use the roster to go into payor spaces. And then I think in the last three months, four months, I had heard that they were accepting new providers on the ads tab on that roster. So that’s good to know. Okay. And I didn’t have anything else as far as the issue tracker goes. Was there anything else that you all wanted to call out on here?
Deanna (10:57) I don’t have anything now, no.
Kim Martin (11:00) Yeah, I don’t have anything else.
Leigh Howle (11:03) Okay. I personally tried Christina robinson today. With horizon. I cleared the cache. I did everything that they have instructed us to do. And I still got an error code on submission. It’s a decal.
Deanna (11:18) Yeah. Our workaround. Basically, they’ve told us to mail in an application. Okay?
Leigh Howle (11:25) So, should, so all, and it might just be easier just to do like instructions. If the error code pops up, the application should be printed. All the supporting documents should be included and it should just be.
Deanna (11:39) Both agreements. Yes.
Leigh Howle (11:40) Yeah, right. The ppo and the managed care. Yeah.
Deanna (11:43) It’s going to be slower but that’s I know that that’s the workaround we’ve been told for a couple of years and there’s.
Leigh Howle (11:51) no way that the rep could just receive those in an email and send it over for processing.
Deanna (11:58) They.
Kim Martin (11:59) won’t do it. Well.
Leigh Howle (12:01) There, I know there’s another client of mine and that rep is doing it.
Deanna (12:07) We don’t have a rep. We have a contract person. He has nothing to do with credentialing. So, everything he’s done for us has been a favor.
Leigh Howle (12:14) Oh, that may, that explains it. So you, so ent hasn’t been assigned a rep for, I think it’s under they have.
Deanna (12:26) Over the years, but they just come and they go. And then they never get told who the new one is.
Leigh Howle (12:35) Okay. I mean… they just, they need to get it fixed, whatever they’ve got going on with, their glitches with the caqh. And I know at one point they were trying to migrate over to availity for new enrollment. The demographic updates can be done in availity with the maintenance app. And so, you know, so that’s okay. But it’s just these new enrollments that are just a challenge with, the errors.
Deanna (13:10) Yeah, I’ve yeah, I run into that because I’ve seen everybody else struggle. So I just try, you know, going in there and messing around to see if I can get it submitted and they’ll come back at me with a correction, but at least it’s submitted and I can’t even get past the error message, you know?
Leigh Howle (13:29) What’s so strange is one time I was playing around with caqh trying to get it to go through and I added a fax number and a website under the practice location, and it went through. It’s just random things in caqh. How frustrating is it to you?
Deanna (13:50) It could be, well, it could be, but I mean, we have, unfortunately, we can’t convince our CEO that adding in every single location for every single provider is one, not sustainable one feasible. And it’s just not manageable for the payers on their end. And so we just don’t have the resources to go through every single one to make sure it was a website. I mean, I know there’s phones and faxes for every single one. I can guarantee that. But as far as websites, no, that was a new field recently and that’s just never been updated. Yes, we can only going forward, we can’t go back.
Leigh Howle (14:21) Yeah, right. That makes sense. I get it. Yeah. And it’s a lot of time to go in and add all that and then just go back and forth between all those locations to try to get horizon of all payers to process the application. So, I.
Deanna (14:35) get it. It’s a nightmare and then we change, you know, locations here, like people change their underwear, and we can’t even keep up it’s just, no one understands we can’t make them understand how much extra work for no return on investment this is.
Leigh Howle (14:51) Right. Yeah. And providers, will, you know, they do move around a lot and, you know, they’ll want to go, they’ll want to take a certain payer or a certain type of insurance and then they don’t want to take a certain type of insurance. They don’t have.
Deanna (15:10) That option anymore in our group. So, but they do, I mean, our guys go and they want a vacation in the hamptons, but they still want to see patients. It’s like, why are you on vacation?
Leigh Howle (15:20) Yeah.
Deanna (15:21) I mean, that doesn’t happen that often. The audiologists are the ones for us that usually move around a lot.
Leigh Howle (15:27) Right. Yeah. Okay. All right. Well, that was all I had, you know, and I’ll let the team know if they get the error just to print it, mail it and document everything in the notes. And then just to follow up with horizon to make sure that they received that application, they can give that information over the phone and make sure it’s in process.
Deanna (15:49) Yeah, that’s better. I think that’s the only workaround for now. I mean, they really don’t want to accept paper applications, but then they really need to get their act together. You call it credentialing people and they’ve just had it. They’re like, yeah, you know, there’s a lot of problems. So just mail it in. Okay. Yeah.
Leigh Howle (16:04) All right. Well, I appreciate your time today, ladies. Did you all have anything else that you wanted to go over?
Deanna (16:12) No, nope. I think I’m good. We’re all set. Thank you.
Leigh Howle (16:15) Okay. Well, have a great rest of your afternoon and I’ll see you in a couple weeks, all right.
Deanna (16:19) Bye bye.
Leigh Howle (16:19) Thanks. Bye bye.