Transcript
Connor Morley (00:00) hello? Good morning. Alright?
Connor Morley (00:14) Hey, Julie.
Connor Morley (00:33) I think we’re just waiting on Alicia and Jenny.
Connor Morley (01:24) Okay. We’ll take a few minutes waiting for everyone to join. No worries. If you have to call in.
Alicia Iannece (02:11) Hi guys. Sorry, I’m a little late.
Connor Morley (02:14) No worries. Hey, Alicia. All right. Did we want to start on the provider enrollments?
Alicia Iannece (02:27) Yeah, we can. Okay. All right. I sent over my questions. Does anyone have those immediately available? I?
Connor Morley (02:37) Have to grab them one second?
Connor Morley (02:45) Because I’m trying to pull… both the spreadsheet and your email, okay?
Connor Morley (02:58) For the provider enrollments currently processing in medallion, those should not be on the spreadsheet, okay, perfect. Yeah, because they’re essentially already loaded.
Alicia Iannece (03:10) Okay. Sounds good. That’s what I figured. But I wanted to make sure.
Connor Morley (03:13) Yep. No worries.
Alicia Iannece (03:16) And then the next question being kind of similar. But so… with aspyrus, we have apparently, it’s two very like separate ways to process them, the commercial plans and the medicare advantage plans.
Alicia Iannece (03:34) So, we had a few providers, a couple of providers, just two that had already been approved for the commercial plan, but they were still pending or sorry, they were not submitted for medicare advantage. So we submitted those in medallion for just medicare advantage. So, I’m trying to figure out how do we reflect that on the spreadsheet? So I.
Connor Morley (04:01) think we would only include on the spreadsheet, the aspyrus commercial. So in the line of business, we would leave off aspyrus medicare advantage. Oh.
Alicia Iannece (04:14) I should put medicare advantage would be false, right?
Connor Morley (04:17) Yeah, yeah, because that’s currently in process?
Alicia Iannece (04:20) Okay, perfect. I’ll do that.
Alicia Iannece (04:30) And then what was my next question there? It’s.
Connor Morley (04:34) about pharmacists, yes.
Alicia Iannece (04:36) So based on how the report built out the spreadsheet, it put. So the pharmacists are only, they’re only par with like 10 or 11 payers, the ones that do it’s, medicare, sorry, medicaid, traditional or managed medicaid, and there’s some that payers that haven’t fully gone through the process yet. Like it’s newer. So, I’m going to have those ones as non par and that even includes like our delegated ones just because we don’t have a managed medicaid program. So, does that sound like that is correct to do it that way?
Connor Morley (05:17) So, you’re… loading on the spreadsheet for those pharmacists, you’re putting in par and for medicaid and some managed medicaid, payers, right?
Connor Morley (05:30) Yes. And then you also want to document within the system, all of the payers that are non medicaid that they are non par with, right?
Alicia Iannece (05:42) Well, I guess I didn’t know if I needed to or not. And because technically down the road, if those other payers, you know, approve pharmacists as providers, then, we would process those ones then. So it’s really just whether… I.
Connor Morley (06:07) Think so. For any non par payers, it kind of depends. Do you want that level of information on their profile? Yeah. Like I’m like what I’m trying to get at is for the par enrollments definitely have them as a line in the spreadsheet. But for the non par, because I’m thinking if you wanted to include like non par information on a, on payers for these pharmacists, it would have to be a separate line because I don’t know if we can split out par versus non par in a single line for, by like line of business.
Alicia Iannece (06:49) Sure. Yeah, that makes sense. And at.
Connor Morley (06:53) least Adalee, correct me if I’m wrong there. I don’t think there’s a way to specify if a certain line of business is par versus non par in a single data import row. Yeah.
Adalee Arreola (07:08) I think we’ve made some updates on that, but it’s something that we would have to confirm on our end. I can do some testing so I can get like a definitive answer on that… but historically, it used to be no, but I think we might have made some changes there. Okay?
Connor Morley (07:30) But I mean, Alicia, up to you, we can leave them off for now for the non pars, and then we can always add them in later too. Okay? Yeah.
Alicia Iannece (07:41) Because I think, and I was thinking about it, how we did the group enrollments because… for the pharmacists, it’s that group of the RMC pharmacy. I’m… just trying to pull it up quickly. There, it is okay. The RMC pharmacy billing group, we did end up for the group putting in all of the payers, whether they were par or non par.
Alicia Iannece (08:15) Yeah. So I think at the provider level, then it will make sense to just do it for the ones that are par. Okay. Yeah. And I’ll take out the non pars. Does that sound good? Julie?
Alicia Iannece (08:33) Yeah. I think that is how we should do it. Okay? Sounds good. I’m gonna write down some notes. So I don’t forget and.
Connor Morley (08:44) then this next one versus like direct enrollment versus no credentialing required.
Alicia Iannece (08:52) I mean.
Connor Morley (08:52) I think Rheta, this is essentially group enrollment versus, I… think so direct enrollment is essentially, we go to the payer and we directly enroll, that provider with that payer, like no credentialing required is almost like a roster or like.
Alicia Iannece (09:13) The delegated ones. Yeah.
Connor Morley (09:15) Okay. And then Rheta, can you also confirm if it’s group enrollments as well?
Connor Morley (09:25) Or par and par linked to group you get?
Rheta Larson (09:28) The question too, some periods now require more for the hospital based providers?
Rheta Larson (09:39) I can double check for group, but I think it should follow the same for the individual enrollments. Yeah, because.
Alicia Iannece (09:50) I’m thinking like our emergency providers, some payers, those ones would be no credentialing required, right? Like they wouldn’t have to process at all. And then others like anyone that we do have to submit an email or form or go to the website like those ones I’m putting direct enrollment for yep.
Rheta Larson (10:14) Yeah. I think that that’s correct there. Okay? And I can double check on the group portion too, Connor just to make sure. And I,
Alicia Iannece (10:23) yeah. I think my, the confusing one was like thinking about medicaid, how if they’re already enrolled with medicaid, like technically, yes, they would need direct enrollment, but if they’re already enrolled, then we wouldn’t need to do credentialing. So, I mean, in Wisconsin, and, you know, they don’t need to be linked to our group if all of those criteria apply. So, I didn’t know if just because it’s medicaid and technically you would need to enroll a provider if they’re brand new, like would I put direct enrollment for those? Or since they’re already established, I didn’t know if it matters.
Rheta Larson (10:55) Yeah. I know we had filled you in last week on one of the payers where we were going to approve as is, but it turns out we did some further digging for that pair and we do need to proceed with, I’m… trying to see which pair it was for. I don’t know if you had a chance to review my email. I didn’t.
Alicia Iannece (11:20) I was going to this morning but then I had some issues to deal with that’s. Okay?
Rheta Larson (11:26) Yeah. So I’ll add this one as well just to make sure just because I don’t want to misinform… you. But essentially it was for tricare. I know we mentioned we can mark those as approved, but we looked into it and at least for non network payers, the group. So you all still need to enter the line request and input the note line stating that you would like the provider enrolled as a non network provider. So I’m going to take this one back as well and just make sure for medicaid, there isn’t any nuance.
Alicia Iannece (11:58) Okay. So there is still some enrollment that gets completed?
Rheta Larson (12:04) Right. Correct.
Alicia Iannece (12:05) Okay. And we’ll add notes for that one. Yep. Yeah, I.
Rheta Larson (12:12) don’t mean to jump ahead. I’m just, no, that’s okay. I don’t want to affirmatively answer it. And the team comes back and says, well, actually we need to do X y and Z for medicaid. Okay. So I’ll take medicaid as an action item too. Okay?
Alicia Iannece (12:31) So, when we’re if we’re submitting like new enrollment requests for all of our payers, do the notes? Can the notes? Be it’s… I feel like it’s one notes section, right? And then it, would it potentially apply to all? Like should we, for these ones that are nuanced, would we submit them separately so that note specifically goes on that new enrollment request?
Rheta Larson (13:00) Are you asking if you can bulk update the request note?
Alicia Iannece (13:03) Well, or specify it to a specific payer besides like putting in the notes for tricare, like I’m just thinking about how… our, I think when we did the couple so far, you know, if we selected all the payers, and the different lines, you know, confirmed lines of businesses, and the locations, then I think it’s just one notes box that pops up so that note would potentially apply onto all enrollment requests even if it’s not applicable to that payer, right?
Rheta Larson (13:37) Right. Yeah. So just make sure when you’re doing the bulk requests and you’re putting that note, it’s relevant to like if you want to do it in groups of payers, then I would suggest that to apply the note to all. Okay? Like mass for all payers, okay? But happy to help there as well if there’s something you need to divide and conquer, okay?
Rheta Larson (14:03) Cool. But I know as far as those additional questions that you had for that enrollment piece for the spreadsheet, was there anything else? Because I know we invited Adalee to this? So I want to make sure Adalee, if you want to continue to be present or if there’s no other questions there, we can have Adalee drop.
Alicia Iannece (14:28) Yeah. I think that’s it. I will just call out. I totally cheated and used chatgpt to figure out how to combine these spreadsheets. And it took me like less than a half an hour. So if you guys want my, you know, I can’t remember what it’s called when you get the printout of the conversation with chatgpt but I’ve got that if that’s helpful to you guys to share because it was very straightforward as far as like putting the two spreadsheets as long as the columns were named the same for it to compare. And then I just did some cross checking, you know, with the ones that I knew were a little bit confusing and I think I had one error that I had to correct with maybe one of the locations had an extra space in it or something and it impacted one provider. But otherwise, it was pretty, it was very straightforward to build that. So if that’s helpful, just let me know, yeah, Alicia.
Adalee Arreola (15:27) I would say that would be helpful to see the prompt that you used just to make sure that, you know the logic that, I mean, I think you did it perfectly, but just to make sure that everything was taken into consideration. And then I don’t see… any of that data on the data import template yet, did you?
Alicia Iannece (15:47) Do that? Yeah, I’ve still got it on my own and I’ll copy and paste it over when I’m done.
Adalee Arreola (15:52) Awesome. Sounds good. Thank you.
Rheta Larson (16:02) All right… Connor. I don’t know if there’s anything else from your perspective, but I have the email from yesterday that I sent over just some of those remaining follow up and action items we have, but happy to give you the floor to continue through anything on your end before I start there. Nope I.
Connor Morley (16:23) think we can start running through those follow ups, okay?
Rheta Larson (16:28) So, there’s a few things we’re still waiting for feedback on, but I did highlight those. I think the first one we chatted through was Ariel bodiker, for the credentials by proxy. We discussed that y’all would be disabling those enrollments by individual profiles internally. So, I think we were questioning if y’all would be charged for that. I’ve sent that over to Nick and he’s gonna hopefully look into it with accounting just to see what we can do there for the credit charge. But how did the disabling go? Are y’all, feeling comfortable with that? Is there any questions there?
Alicia Iannece (17:02) Yeah, I think Jenny was able to do it. We had looked at a few others. Yeah, we’ve been she’s out this week, but last week we took a look at the, what was coming due and what was scheduled, and then either getting some going that needed to be scheduled that didn’t have dates.
Alicia Iannece (17:21) And then, yeah, disabling. I think it was just this one and maybe a couple to disable, but removing those dates and putting a not applicable. I think she did that for everybody or at least the ones that with the closest dates coming up. So that should be good. Yeah. Okay.
Rheta Larson (17:41) Great. As soon as I hear back, I’ll definitely let you know, but it’s been placed to the appropriate teams and I’ll make sure to keep that on our radar. The next item was the privileges to admit. I know you stressed the importance of the majority of the providers do not have the privilege to admit. So I think that was where we walked through the hospital affiliations record where you’re adding that. And that drop down was auto populating to type as admitting. I did provide that feedback to product support and I think they just need more information and clarity to fully understand and grasp what the issue would be there. But I’m working with them internally just to make sure it makes sense in the lines before we put engineering support and energies on there. I think in the interim, like I mentioned, just make sure that the providers are reading through those questions. If they’re not admitting, they just need to select the drop down and select not admitting. But with that, I know there were in flight applications that maybe you had flagged the work history and the hospital affiliations may have been listed incorrectly. So we wanted to do a quick audit on those. I don’t know how far along you’ve gotten in your audit, but I know Jen is working on getting that prepped and ready to review this week. So she most likely will be reaching out to you just in this thread that we put together.
Alicia Iannece (19:10) Okay. Yeah. I haven’t gotten far but I do have time today that I’m hoping to look at some more of them.
Rheta Larson (19:17) Okay. Yeah. She’s also stated she’ll work on that this week. Okay. I’ll let Connor take this next bullet point for privilege forms for the dop forms that couldn’t collect the signatures. I know we sent that off to the engineers for review. But Connor, if there’s anything else to add there for update? Yeah. So.
Connor Morley (19:37) We hijacked dr baker’s user account and we were able to look and kind of have the ability to sign. I had a question that, you know, is it possible that there’s some sort of pop up blocker on the RMC side? Or maybe we’re getting blocked through our like reedsburg it department?
Alicia Iannece (20:09) I can ask them.
Alicia Iannece (20:14) I know I’m not logged in as her, but I’m not seeing anything popping up. We did have one provider succeed… at typing their name into that section. That signature section. Is that what’s expected or is the signature is their prior signature that’s saved? Is that supposed to pull in? Like what is supposed to happen? They should be?
Connor Morley (20:36) Able to sign similar to… how they did for the agreements. So, right, okay. One second, let me hijack dr baker’s and show you… but while I’m doing that Rheta, if you want to go to the next one.
Alicia Iannece (20:58) Like I’m taking a look at… I don’t know if you have marked their stuff complete, but they… haven’t actually signed it.
Alicia Iannece (21:19) Oh, it was, Olsen, was the one who succeeded. I just remembered I was on a phone call with him.
Alicia Iannece (21:32) He’s in the completed tasks. So he was able to do it, but he had to type his name into the signature line.
Connor Morley (21:50) I mean, dr baker signed it.
Alicia Iannece (21:59) This is the one I’m talking about Kenneth Olsen. Yeah, I see.
Rheta Larson (22:03) His notes, he said that he typed his name in the signature field, but had no way to actually sign the document. We marked it as completed though.
Connor Morley (22:23) All right. Let me,
Alicia Iannece (22:31) I can talk to my, it, but I don’t I mean, if there, if we were having a pop up blocker, like wouldn’t I see that somewhere in my screen. All right?
Connor Morley (22:42) Let me go back to engineering.
Alicia Iannece (23:12) We did have another one work, but she put her email address… she typed it in also, last name is Greer Alana, Greer, GR, IER.
Connor Morley (23:43) I have a meeting with our engineering team later today anyway. So let me bring… that back up to them because it’s not. Yeah, I don’t doesn’t… based on what you’re saying, I don’t think it’s a pop up blocker anymore.
Alicia Iannece (24:03) Yeah, it looks like some of them are completing the task just based on everything but the signature because they probably don’t know how to get that part done. We’ve got five in the completed tasks.
Connor Morley (24:20) What was the other provider’s name?
Alicia Iannece (24:23) Greer GRIER, she typed in the signature section, but she put her email address.
Alicia Iannece (24:34) Okay. No worries. I’ll show you one more time.
Connor Morley (24:40) GRIER. Interesting. Okay.
Alicia Iannece (24:47) And then there’s a few more in here, but they don’t look like they’re right? I didn’t check this one yet. But, yeah, I guess there’s blank.
Connor Morley (25:03) All right. Let me, all right. I just pinged… our engineering team, Karen and Patrick again to see if they can help a little more. There’s a bunch.
Alicia Iannece (25:20) In review also, well, not a bunch, just three but these ones don’t look quite right either. So just any of the tasks that are saying complete or in review.
Alicia Iannece (25:43) And this one says all complete, but then no signature and.
Connor Morley (25:49) All right. Let me take a look at that a little further. All right. Okay.
Rheta Larson (26:02) Yeah, we can use those examples. And then I know we have Greer and Olson as examples as well where they completed it, but they typed it in or put their email. So we’ll get back to you on that one as an open item. Anything else with the dop forms before I move on to the next bullet point? No. Okay. Board certifications. I know this is or this was an outstanding topic. I don’t know what we’ve been going back and forth on. So I did just double check with both of our credentialing and privileging team just to make sure we’re aligned here. This time, board certification monitoring outside of initial appointment and reappointment would be out of scope. Typically, we do put that back on the client in between appointment cycles. So I kind of just laid out like we would expect that the client maintains responsibility for board certification monitoring and expirable tracking and follow up. And then we continue to verify at initial and then reappointment so that in between time would essentially fall to our AMC. I don’t know. I did also check with the team because I know we have that click that verify button where we showed you last time while we were walking through it live. I don’t think you all have the ability to do that. I’m still checking to confirm. Yeah, I think that’s just an internal because when you do pull, it doesn’t pull to any packet since there’s no like associated request with it. So technically it will reach out and like validate it, but it’s not going to go anywhere like the document won’t go anywhere. So that’s why it’s not like something we give visibility to provide admins. But I’ll pause there because I know you mentioned that was an audit risk but maybe not as well well.
Alicia Iannece (27:53) Yeah. So I dug into our bylaws and our bylaws only talks about appointment and reappointment also. So, I will, we are going to reach out. We’re going to like kind of query the joint commission and just ask them from their perspective regarding the monitoring, the in between monitoring and just see what they expect… that’s going to be our next step.
Rheta Larson (28:18) Okay, perfect. Yeah, if you get any feedback or hear anything different, let me know. I’m happy to take that information to the team and we can work together there. But, as of right now, I just want to make sure we did answer that and kind of put that one aside until you hear back. Okay, any other questions on the board certifications?
Alicia Iannece (28:42) I guess, I think, yeah, if it was something, if we do have to do it, if it was something that we requested at the time that they come do, like, is that a?
Rheta Larson (28:53) Possibility?
Alicia Iannece (28:53) That medallion might still do it and charge for the, you know, pass through fees or whatever. But is that a possibility if we were to request them when they come do? Yeah, that’s what I.
Rheta Larson (29:06) was trying to ask the team yesterday because technically we can like, we can pull it, request it. You’ll get charged for it, but the document itself doesn’t necessarily go anywhere. So that’s like the missing piece, like it doesn’t update it. It, it does update, but it’s not going, it’s not getting attached to anything. Let me see. I don’t know if you would have the ability to pull it, is my concern.
Alicia Iannece (29:33) Or like see well, I think we’d probably just have to go and create accounts and stuff, but.
Rheta Larson (29:41) Yeah. I mean, if that works for you because it doesn’t pull into a packet but, again, I would need to confirm with the team. Like if we do that workflow, is that going to disrupt anything? If we’re pulling in between cycles, the possibility, is there you would get charged for it? So, you know, if that’s something and then we would have to internally seek to see if we can create a workflow based off of that because it currently isn’t something we support or we do for other clients?
Alicia Iannece (30:06) Sure. Okay. But.
Rheta Larson (30:10) Yeah. Good question. I was also asking that. I was like, if we have to, can we just click it are?
Alicia Iannece (30:14) Any of those other clients joint commission accredited? Like I’m just so curious to hear maybe what they’re doing if they’re doing it in the interim? Like, is that something you guys can ask?
Rheta Larson (30:27) Yeah. I do think there are a few. I can check with my team internally to see if anyone else has flagged this concern. Some of the other engagement managers were part of that conversation and they related to this portion, but it was the same outcome like we just don’t maintain it currently. Okay? But yeah, I can loop them in.
Rheta Larson (30:56) Okay. Any other questions with board certifications?
Alicia Iannece (30:59) No. All right.
Rheta Larson (31:03) Revalidations. This is now dropping into some of the parent enrollment, outstanding items. I know you had sent the list of the provider enrollments that were submitted as an initial enrollment, but the notes indicated it should be a revalidation. I went to those with the team live last late last week. We went through each line item. We identified the ones that were submitted as initial versus revalidation. I think out of the six or seven, there was five. So like one was submitted correctly and the rest were submitted incorrectly. So there’s a few things here. The team is going to work on resubmitting those as revalidations in the same lines. There’s no further requests you have to input there. They’ll get those corrected for that list that you sent. And then I did stress the importance of when you are inputting notes, is the team checking those, that is a part of their workflow? So I just had those managers of the PE teams reiterate to the teams like make sure you’re slowing down, checking their requests, reading the notes. It is also a part of their internal audit. So that is something that we are internally tracking and measuring. So hopefully this doesn’t become an issue and you don’t see it frequently. But we definitely have held the coaching with the team to pay attention to those notes moving forward.
Alicia Iannece (32:23) Okay. And now those, my notes were clear, right? Like I just want to make sure should I have said something else to help, you know, point in the right direction? But, okay. Yeah, I just wanted to make sure that they were clear.
Rheta Larson (32:36) Enough too. They were clear. Yeah. And I also explained like the reason why you’re doing it this manner is because we’re not necessarily out of the implementation phase, but I think moving forward. Once that is kind of all squared away, it shouldn’t really pose an issue because you.
Alicia Iannece (32:49) would be able to right? It won’t because we’ll be doing them as revalidations. Yeah. Okay. Thank you. I know. I knew it was a risk putting them in as new enrollment requests anyways. No.
Rheta Larson (33:00) Worries. Any other questions on those revalidations?
Alicia Iannece (33:06) Can you just, do you have the list? Do you know which ones are going to be resubmitted?
Rheta Larson (33:11) Yes. Let me pull. It is going to be.
Rheta Larson (33:29) Eagle newsome. Oh, that one’s not going to be. That one has not even moved through. When I checked, it wasn’t an intake complete yet, so you can cross them off the list. Okay? Gerrit, gerritinson, MHS, gerritinson, okay. Yeah, gerritin, MHS, and aspiris, those two will be resubmitted, mcgaffey, MHS, and then Stacey warnicke for eye care. So, those four plus… a list of polk, which we already completed, so that’s technically five. And then fiebel, Newlin did not have to be resubmitted.
Alicia Iannece (34:05) Okay. And polk was MHS too, right?
Rheta Larson (34:09) Polk was, yeah… no security health plan, sorry.
Alicia Iannece (34:16) Oh, security. Okay. Thank you.
Rheta Larson (34:24) all right. I meet with them right after the sync. So I’ll just get a pulse check on where we’re at, and you should be able to see the new notes on those and just an update for the new resubmissions.
Alicia Iannece (34:35) Sounds good.
Rheta Larson (34:38) Aspyrus. I know we chatted through this last.
Alicia Iannece (34:42) week.
Rheta Larson (34:42) As well. And I think your team or Peter, if I’m not mistaken… kind of stressed the importance that aspyrus is, we saw the email that they’re a little upset that we’re reaching out frequently prior or post application submission. They need time to kind of digest the application, review it. Make sure. So, I think it was the 40 fifth day that y’all had confirmed, but you want us to reach out on the thirtieth day. So, I’ve explained that to the team. They are aware that… there’s a handful of payers that are like this honestly, and we’re still trying to understand which payers those are. I don’t have a list of them. Unfortunately, internally we’re working on those, but aspirus is one we added to the list. So what our team now is doing is we’ve coached a team to reach out to the payer on the thirtieth day, post application submission. Again, that does not stop us from updating the notes for that biweekly cadence, but it will include a payer update.
Alicia Iannece (35:45) Yeah.
Rheta Larson (35:47) Additionally, when we reach out to the payers, I know aspirus has asked that we submit the application with the email and query. So we’re coaching them to download the PDF and attach it that way each time they reach out. And then we’re still reviewing the email access. The pa team seemed positive… that they’re able to do that with the individual email access. So once I get word back on that one, I’ll let you all know.
Alicia Iannece (36:12) Okay. That was like for access to the portal, right?
Rheta Larson (36:15) Okay. Yeah. But other than that, I just want to let you know the conversation has been held, the team is aware and they’re working on it internally with the team that’s not to say, I mean human error may occur. So definitely, if you see that flag it and we can get it corrected.
Alicia Iannece (36:31) Yeah. And I mean, as long as you’re fine, I just keep forwarding emails to you guys. Like I guess sometimes… if we’re getting and this is just kind of more in general. But if we’re getting feedback from a payer like specific to a specific application, do we forward that email to support? Like what’s the best route for sending that feedback? Is it forwarding to support? Is it, or the help, the new email? The help at medtrainer? Is it copying you guys and sending it to you guys? Is it posting it in the notes? Is it doing all of those things? I guess I don’t know what the best route is.
Rheta Larson (37:15) Yeah. Some folks do everything just to make sure the message is getting across everywhere. I know that’s a little bit overkill but we’re kind of in a unique phase because we’re still in implementation. So I would say continue to send things to myself. Connor those cc’d on the email that you’re working with for this part of the kickoff and then post implementation that’s where I’ll kind of take over and we’ll handle these operational things moving forward. I usually direct folks to send items to support. If it’s like low hanging fruit. I would say if it’s urgent, definitely loop me in support can take up to three business days to get back. So that’s the only call up that I will say there. It’s not to say that they will take the full three days but it could take up to 72 hours to answer the question. I usually am cc’d on those tickets anyway. So if you do submit support, I should be able to get them as well. But if it’s something urgent, please loop me in. I’m happy to take a look at it. And then I’ll get back to you as well. Hopefully that answers your question. I know we’re kind of in a weird phase right now where there’s multiple email threads going for other things.
Alicia Iannece (38:24) As well. Okay. Yeah. And I think… what if this was, and yeah, some of it all blends together. But the one of the maybe feedback we had received from a payer, I had put it in the notes section assuming it wouldn’t get done immediately, right? Because of the follow up period, right?
Alicia Iannece (38:44) But I think the notes maybe got disregarded again kind of it was asking for additional information. And then when I looked back at kind of what the medallion team had had posted in the notes for what they had done for follow up. Like they didn’t take into my considerate, like taking the consideration of my notes that had the additional questions that needed to be answered. So then it was the payer reaching out and saying again like, you never provided these answers to this stuff. And I had already… sent that weeks prior. So, and, I think I ended up just sending it on because I wasn’t sure if medallion had gotten it or had taken care of it or not. So I went ahead and forwarded it on to the payer just in case. Yeah.
Rheta Larson (39:33) Those ones I would say just loop me in and I’m happy to work with the team there. The notes are great because the team should be checking those. Like I mentioned in my last bullet point like that is a part of our process. We don’t communicate via notes. However. So if someone is working on the file and they see the note, they’re not going to respond directly to you via note. You won’t get alerted there, but they will try to do a review of those items that come through. So that’s good, you know, good feedback. I can give to the team as well. Yeah… if you have any of those examples, feel free to send them my way because I love to show those as well to the team.
Alicia Iannece (40:10) Okay. Do you want me to try and go back and find the couple that I did last week?
Rheta Larson (40:15) You don’t have to, if it’s going to create extra work. I’m just saying looking forward if you find those, just send them my way so that way I can take a look at them. Okay?
Alicia Iannece (40:23) I will say for eye care, they require like a separate few pages of like questions and… typically question number five is like a, it’s like a big question where it’s like number five and it’s like have you ever had negative actions on? And then it goes into like licensure privileges boards like all these other things. And eye care wants an answer in each box of number five. And it’s like six or seven boxes within that one question. So what medallion had done is they had answered the question of like the overarching number five. They marked no, but they didn’t go into the individual ones and put no. So, and I noticed it on, it happened on a couple. So that’s why I went ahead and took care of those since a few had been sitting for a while already. But yeah. So I think that’s an easy one for maybe in the initial kind of notes for doing eye care enrollments to make sure question five has an answer in every single box? You a screenshot of that if you want, yeah.
Rheta Larson (41:31) That would be helpful… as a note.
Alicia Iannece (41:40) Do you have it easily accessible? Do you remember those emails?
Alicia Iannece (41:49) What is accessible? That eye care, the question number five that wasn’t getting, filled out all the way if not, no worries. I can go find it.
Rheta Larson (42:03) Well, I can also pull a few examples but that is helpful.
Alicia Iannece (42:11) Been, Stacey. Warnke, might have been one of.
Rheta Larson (42:15) them. Okay. Gotcha.
Alicia Iannece (42:16) I can use that peek here real quick too.
Alicia Iannece (42:24) Pulling her.
Alicia Iannece (42:29) Danielle legal and Stacey warnke.
Rheta Larson (42:33) I see the recredential continue and there’s all… these questions. Has your license registration? Have you ever? Yeah?
Alicia Iannece (42:44) Okay. I got the page. So I corrected that page and I went ahead and sent it to the payer.
Alicia Iannece (42:57) Part too because they’re still emailing us and so I think that was one of the questions whether to make, would I put that reedsburg area medical center at medallion team? Give them that contact information to reach out directly to medallion with follow up stuff like this? Yes?
Rheta Larson (43:17) Yeah, for payer, enrollment request, that would be the correct email. Okay. I took eight eye care as an example. So I have that one and I can get that reviewed as well. Any other questions with… those… aspiris, the coaching health with the individuals?
Rheta Larson (43:45) My last two bullet points is the parent moment for tricare for tens and Sean smith. So this is the one where I think I had explained to you live in the scene that the team said it was fine to approve us. Is they did some digging and then they did confirm that we should not mark those as approved as is. So they confirmed an enrollment request would still have to be submitted to the payer for the provider to be enrolled as a non network provider. And I linked out… that… email or sorry, that web information that provided the non network provider information applications for tricare. So definitely take a look at that. Let me know if you have any questions. But per rpe team, you all would still need to enter the line request and input a note on the line stating that they just need to be non network providers or they need to be on network. So I think we did it correctly for tens and Sean smith if I’m not mistaken. Okay?
Alicia Iannece (44:57) Something come up with a different provider with tricare last week. And I am wondering if maybe… his revalidation for being a non network provider, didn’t happen within… something Rheta, that you or your team could go and investigate or would I need to look into tricare to see if non network providers need to be revalidated? Yeah.
Rheta Larson (45:30) If we have the request, are we working on an open request for them?
Alicia Iannece (45:33) Not yet, no, but he just got word that tricare was saying he wasn’t enrolled at all, and, he probably was at one point and that we’ve there’s also been issues because tricare switched their regions, like, right? That impacted us. So, we were previously tricare east and like up to a year ago, now we’re tricare west. So, there were a bunch of just questions that popped up because of that too. So, I just know it’s been a little bit wonky. That we haven’t.
16085246477 (46:10) really know for.
Alicia Iannece (46:10) Sure. And we were told that they don’t we didn’t previously have to enroll providers, so I don’t know for sure. Yeah.
16085246477 (46:18) If we don’t.
Rheta Larson (46:18) have a tied request, the team typically won’t explore because we have nowhere to update that information. I can take this as a one off and see if the team can like help support. But I would just need the provider’s information, but,
16085246477 (46:32) yeah, that’s usually.
Rheta Larson (46:33) Something we ask you all to just let us know prior to submitting the requests. Obviously, once we get the request, if something does come back from the payer, we let y’all, know in the notes like, hey, this writer is already enrolled or they need X, y and Z and then we’ll direct you to input the request for whatever is lacking for the payer.
Alicia Iannece (46:50) Okay. But,
16085246477 (46:53) let.
Rheta Larson (46:53) me know if you need.
16085246477 (46:55) Assistance?
Rheta Larson (46:56) There, if you want us to help support, I just need the provider’s name and info. Okay? Any other questions on tricare?
16085246477 (47:09) No.
Rheta Larson (47:13) Let me make a note on that one. We’ll send provider info with.
16085246477 (47:18) Assistance.
Rheta Larson (47:23) And lastly, I think this one was also talked about where we were outstanding. How.
16085246477 (47:30) to.
Rheta Larson (47:31) differentiate the two for par linked to group versus par, not linked to group?
16085246477 (47:36) PE?
Rheta Larson (47:38) Had a few questions. They are just asking if will.
16085246477 (47:45) the providers already?
Rheta Larson (47:45) Be enrolled with Wisconsin MCD? Or would medallion need to complete their initial enrollments… like mark and Benjamin. Does that apply to them? Are we doing their initial enrollments?
Alicia Iannece (47:59) No. So, they’re already enrolled. They’re par currently now,
16085246477 (48:07) I think if we’re thinking?
Alicia Iannece (48:09) About in the future with a new provider like?
16085246477 (48:13) Mark?
Alicia Iannece (48:14) Meyer would.
16085246477 (48:16) Be the type of,
Alicia Iannece (48:16) provider that we would not link. We would not need to link to our emc. And if they’re already enrolled, then we would probably just submit them as.
16085246477 (48:25) A new enrollment request that.
Alicia Iannece (48:27) We would manage and just put, make them par right away.
16085246477 (48:31) Okay.
Rheta Larson (48:32) So, just for clarity, moving forward, those that are already par, you would not ask medallion to complete initial enrollments, you would handle that on your own.
16085246477 (48:45) Yeah. And then… groups submit.
Rheta Larson (48:51) Wisconsin medicaid claims on behalf of the providers or will those providers bill independently?
Alicia Iannece (49:05) The group will submit claims on behalf of the providers.
16085246477 (49:08) Our emc.
Rheta Larson (49:10) Will submit the group will submit Wisconsin medicaid claims.
16085246477 (49:14) Yes.
Rheta Larson (49:18) That’s helpful. I just want to make sure moving forward, we have that workflow correctly. So, I wasn’t able to answer that for them. So this is good.
Alicia Iannece (49:27) And, that was to satisfy one of the spreadsheets… I mean, I don’t know if when.
16085246477 (49:35) we submit.
Alicia Iannece (49:35) New requests, if that’s going to pop up, you know, and I think we’re planning on, you know, if we have a new provider come in, we’re going to ask these questions to ourselves first of.
16085246477 (49:46) Are they in?
Alicia Iannece (49:48) Wisconsin, yes or no? Do?
16085246477 (49:51) They need to?
Alicia Iannece (49:51) Be linked to our group? Yes or no? You know, are we their primary location? If we’re not their primary location, then we’ll specifically say that we wouldn’t need to link them any further, so.
16085246477 (50:03) I think.
Alicia Iannece (50:03) For purposes of requests, I think we’re okay. And then the spreadsheet, I think.
16085246477 (50:08) We ended up deciding that we don’t need.
Alicia Iannece (50:12) to put the medicaid revalidation dates in because… we’re going to be requesting those ones to be done anyways, right?
16085246477 (50:20) So, I’m thinking.
Alicia Iannece (50:22) Maybe we don’t need to.
16085246477 (50:24) Do… anything?
Alicia Iannece (50:27) Else, I think we’re just maybe confirming that whether… they needed to be linked to the group in the current state or?
16085246477 (50:37) Not, yep. Yeah. And I’ll.
Rheta Larson (50:39) make sure we get clarity back from them as well just to align… with the process in general. But yeah, I think you’re I think you’re correct there, yeah. And,
Alicia Iannece (50:52) unless it’s something maybe you know, with this provider enrollment spreadsheet, we’re just putting par, non par, we’re not putting link to the group or not. So.
16085246477 (51:03) Maybe when we put in?
Alicia Iannece (51:04) The revalidation request, we would call out at that point, whether those providers are expected to be linked to the group or not.
16085246477 (51:19) And you said that’s on the spreadsheet? What’s.
Rheta Larson (51:23) that, that’s on the spreadsheet, you have that on the spreadsheet as well?
Alicia Iannece (51:27) No. Sorry on the provider enrollment spreadsheet. It’s just par or non par. There’s not the option for link to group or not linked to group? Okay?
Rheta Larson (51:38) Gotcha.
Alicia Iannece (51:38) But then, so when, like for dr nessum, when we put his revalidation in, would we at that point call out like he’s supposed to be linked to the group or stay linked to the group? But then for dr Meyer, we would call out, he’s not linked to the group or shouldn’t be. So we wouldn’t expect that to change. We would keep that as is.
Rheta Larson (52:00) Right. Okay. Got, it makes sense. And I know last time we had chatted about that as well, just put the notes in and trump, just to make sure, but I know they just came back with further questions. So I’ll provide this to them and I think our workflow of adding the notes is fine there and see we’ll look at those.
16085246477 (52:19) But I.
Rheta Larson (52:19) have that as an outstanding item. So I’ll get with the team right after this just to let them know. But other than that, I think those are the only open questions that I had from that last week sync. Is there anything that I’m missing or anything else you want to chat through with the time remaining?
Alicia Iannece (52:45) For the ceqh management, I’m going?
16085246477 (52:50) To.
Alicia Iannece (52:51) show you guys a screenshot real quick?
Alicia Iannece (53:12) Can you see my screen?
16085246477 (53:15) Yes.
Alicia Iannece (53:17) I.
16085246477 (53:19) was noticing some discrepancies.
Alicia Iannece (53:23) I ended up running a report to look at like profile completions. And then I threw ceqh on there as well just.
16085246477 (53:31) To see if I could see.
Alicia Iannece (53:32) A quick shot of like who’s got this? Who’s got the ceqh added? And who doesn’t you know, to make sure we’re going to be monitoring the right people. And so, it caused me to kind of then look into a few more because some were still being listed as ceqh. Yes, like that, they have it that we have it for them. But, but we shouldn’t.
16085246477 (53:54) so, I just pulled up the.
Alicia Iannece (53:56) Andersons because there were enough of them to show an example, but this, I know make it bigger. Sorry, this Jesse boyette anderson. So he would not be caqh management. So he’s it’s correct that his box isn’t checked. But then in requests, it says caqh management. So he’s still pulled in as a yes in the report that I ran. So.
16085246477 (54:18) It there’s.
Alicia Iannece (54:19) something maybe a little bit, not quite matching up. And then this one’s correct. Sydney anderson. We should have caqh management for her. So that’s correct… Stephen anderson is correct, but Jacob anderson again is similar to Jesse and Elizabeth, these three, they all have caqh listed, but then they’re not marked and it’s correct that we don’t want them marked, but it’s still pulling up as a request and,
16085246477 (54:48) then Becky anderson?
Alicia Iannece (54:49) Is one that we should have it marked? And.
16085246477 (54:53) we should have caqh?
Alicia Iannece (54:54) Management, but she’s not listed here?
Rheta Larson (55:00) Connor, do you happen to know that piece for the import? Is there something on our end? We?
16085246477 (55:07) Can cross?
Rheta Larson (55:08) Compare? Yeah.
16085246477 (55:09) We do have something.
Connor Morley (55:10) That we can cross compare. I thought we had checked off a lot of these if there are any that should be checked.
16085246477 (55:20) Caqh?
Connor Morley (55:23) Management, but no.
Alicia Iannece (55:29) I mean, I think the check marks are closer to correct? Like these five are all correct. This one needed to be marked. So, I think, I’m I think I went ahead and marked her. I can double check here, but, and,
16085246477 (55:44) then just, I didn’t know if.
Alicia Iannece (55:47) that caqh management in the request line is going to mess anything up.
Connor Morley (55:51) No, it won’t as long as caqh is unchecked, it shouldn’t mess things up, but that is definitely a weird one.
Alicia Iannece (56:02) Okay. I did just mark her now.
Connor Morley (56:05) But are those checks correct?
16085246477 (56:08) All, but Becky?
Alicia Iannece (56:10) Anderson, so I just added Becky.
16085246477 (56:13) Becky anderson.
Connor Morley (56:14) Was added in two four joined in two four. Yeah, I can double check and at least I can export a… copy of all of the ones that have been checked… to confirm.
16085246477 (56:37) I did.
Connor Morley (56:38) Hang on.
16085246477 (56:41) One thing in addition.
Connor Morley (56:42) You should have the ability to, I wanted.
16085246477 (56:47) To check this out to?
Connor Morley (56:48) See if you guys have the ability to go in and if you multi select providers, you should have the ability to also.
16085246477 (57:00) Mass check.
Connor Morley (57:01) Caqh management.
Connor Morley (57:11) Which is multiple providers. Yeah. So there, is that enable caqh management button?
Alicia Iannece (57:19) Okay.
16085246477 (57:22) And I can.
Alicia Iannece (57:23) Enable it, but I can’t disable it.
Connor Morley (57:24) Right. You cannot, we have to disable it on our side.
Alicia Iannece (57:28) Okay. And like that’s a good example like this one, Rebecca funk, we are going to manage hers, but not yet. She doesn’t start with us for like five more months yet. So I almost want to take her off for now because.
16085246477 (57:44) she… I,
Alicia Iannece (57:47) can take her off if you’d like, so we should not manage her until what’s… the last name funk? Funk? Yep.
Connor Morley (57:55) Okay. Give me one second. I can take her off.
Connor Morley (58:04) But yeah, if there are any in there that should not be, I can just remove them. Okay? What was her first name? Rebecca funk? Okay. Got it.
16085246477 (58:23) Benjamin.
Connor Morley (58:29) She’s been removed.
Alicia Iannece (58:30) Okay. Thank you. So, will those eventually like match up?
Connor Morley (58:35) Yeah, they should. I think those requests are a little old because we did for some of them. We did go, we did accidentally enable them and then we disabled them. So the request should pull off eventually.
16085246477 (58:52) And actually.
Alicia Iannece (58:54) This Ricardo should pull off should be taken off.
Connor Morley (58:58) And Rory?
Alicia Iannece (58:59) Michelski should be taken off as well. These are new ones. So, I wonder if, and,
16085246477 (59:05) this, josh Kramer it?
Alicia Iannece (59:06) Says caqh. But then it’s not checked. So not checked is correct.
Connor Morley (59:14) A rose needs to come off.
16085246477 (59:22) Rory michelski?
Connor Morley (59:35) R o R y… M a, okay. One second.
Alicia Iannece (59:55) They’ve been removed. Okay? Thank you.
16085246477 (59:59) We’re at time. All right?
Rheta Larson (60:03) Well, I have a few action items. I know we’re going to get with engineering for the dap form. I care if you want to set or I have the example form. But if there’s anything else you want to send, let me know.
Alicia Iannece (60:15) Oh, you don’t need me to send that screenshot?
Rheta Larson (60:17) No, you’re fine. I got it. Sounds good. Tricare revelo, validations for non network provider, I know you’re going to dig into that for that one provider, but let me know if there’s assistance you need there, and then I will get the questions back for par. Okay. I know we meet tomorrow, but if there’s anything you need to address before, then let us know, feel free to send us an email with questions and we can try and get ahead of those.
Alicia Iannece (60:44) Sounds good. I think just since Peter isn’t on today’s, call, maybe with the aspyrus follow up, just plan on touching on that again tomorrow, so he can hear, you know, the follow up you guys have had for that one.
16085246477 (60:58) All right.
Alicia Iannece (61:00) Yeah.
Rheta Larson (61:01) Well, thank you. Have a.
Connor Morley (61:02) Good day. All right. You too. Guys. Bye.