Transcript
Debbie Argentine (00:00) hey, James. Hey, Adam.
James Donachie (00:02) Hey, Debbie. How are you?
Debbie Argentine (00:03) Good. How are you doing?
James Donachie (00:05) Good. Hello?
Adam Pollick (00:08) Hello, there’s, James. What’s going on?
James Donachie (00:11) Not too much, Adam. You officially got your windows open?
Adam Pollick (00:15) It’s all over, but the shouting in New York. I already told Debbie it’s like Tampa here today.
James Donachie (00:25) That’s amazing. It’s more.
Adam Pollick (00:26) Yeah. I thought this morning, I saw it was going to hit 90 today or 89 that’s crazy, believe it or not. Yeah, yeah, record breaking for the region for the state.
Debbie Argentine (00:38) It’s only 76 here.
Adam Pollick (00:40) Oh, we got you, deb, I know we got you. I might have to terminate providers from an outdoor setting… Debbie, do?
James Donachie (00:52) You have your beach back yet? It’s like Easter’s over. It’s a great migration for people started back up to up the east coast and back to the midwest and Florida is calm for a couple of weeks here.
Debbie Argentine (01:06) I think snowbirds start to go home soon. I’m not impacted too much by them. Becky moore. She lives more where snowbirds live, but I don’t know. I haven’t been to the beach yet this year.
James Donachie (01:23) Oh, man. It’s.
Debbie Argentine (01:24) been, it’s not been nice enough. Really… well.
James Donachie (01:28) I get that when you have access probably to the beach whenever you want to go, you can just pick and choose, yeah.
Debbie Argentine (01:34) Yeah. That’s true. I’m not rubbing that in or anything.
Adam Pollick (01:37) Right. You got that. I just have the mighty hudson river behind me.
Debbie Argentine (01:45) I mean, really? I can be on a plane and be in the caribbean in three hours. So, yeah.
Adam Pollick (01:50) Right.
James Donachie (01:51) Right there.
Debbie Argentine (01:52) Are worse things in life?
Adam Pollick (01:53) Yeah, you could depending on where you could probably even get closer depending on where you went like, you just.
Debbie Argentine (01:59) Oh, yeah. We can, we’ll take morning flight like when we go to, you know, st Martin, st Lucia. We’ll take morning flight. We’ll leave as early as we can, you know, seven eight. We’re on the beach by two.
Adam Pollick (02:09) Right. Exactly. Right? You’re like done?
Debbie Argentine (02:12) Yeah, yeah.
James Donachie (02:14) That’s amazing. I,
Adam Pollick (02:15) love that, you could do a caribbean like long weekend with that kind of thing if you get on that first flight out, if you could be set up yep midday. If you did that on a Friday, you could easily do Friday to Sunday or Monday. It’s like no big deal.
Debbie Argentine (02:27) Yeah, we’ve done that with there’s Bahamas. It’s called bimini Bahamas.
Adam Pollick (02:32) Yes, right. Bahamas are a little closer.
Debbie Argentine (02:33) Yeah, it’s off the it’s off the coast of Miami. We just take the ferry over. Now, we have to drive three hours in the car and then the ferry is like two hours, but you drink on the ferry, you have cocktails on the ferry on the way over. And then there’s like a shuttle, a golf cart shuttle waiting to take you to where you need to be. And I mean, we’re there and spend the weekend and come home.
Adam Pollick (02:52) That, there’s something magical about golf cart transportation. Oh, I love it. It’s I did that for the first in Florida, daddy, it was, on the gulf side too. I went, we went years ago. We went twice, it was to north catiba island over by sanibel island.
Debbie Argentine (03:09) Yep. Yeah.
Adam Pollick (03:10) Yeah. We took, I remember, we flew to fort Myers, right? And then you got to get transport over to the coast, but then you just take a boat there. And once you get there, that’s there’s like no cars. I mean, there’s some cars there if you’re like working there. And there’s utility vehicles to do what has to happen there. But, but otherwise, it’s only golf carts to get around there, which was great. I mean, really fun.
Debbie Argentine (03:35) Yep. It’s definitely lovely. Yeah. Well, we can get started. Becky’s going to hop on in a minute.
James Donachie (03:41) Okay. I Debbie the one thing I have and I wasn’t sure if you sent it to me, and I just couldn’t find the email. I need your all powerful written for those archives so I can get them out.
Debbie Argentine (03:55) Yeah. So let me ask you, do you need just one full list or can I send them as I come across them?
James Donachie (04:04) So,
Debbie Argentine (04:04) I think what I’m going to have to do is pull a report that shows which providers are expired and, but have a cred date still loaded in a platform and use that as my guide. Okay? So let me work on that today. I actually this is the only meeting I have today. So I’m working on one project and then let me work on that because I do want to get that taken care of. Well, I’m so glad, we can reverse those.
James Donachie (04:31) Yes. And I also have them. That was like part one of my ticket. And then part two is… I’m making sure that we are, we’re setting the time like the time, the cutoff time, I don’t know what… like I heard, it was supposed to be midnight. I don’t know. I put in a product request. It’s getting looked at, I’m making them go back so that this won’t happen moving forward.
Adam Pollick (05:00) Okay. I,
Debbie Argentine (05:02) mean, you know, ideally we like to be done by five o’clock but there are times when, you know, Liz on my team. She is so like I always tell her, she’s like a dog with a bone in the best way possible and she sinks her teeth in, she just hangs on until it’s done. And she will actually, and I told her, I don’t like her to do that, but she’ll actually leave work, go do her dinner and things like that and log back in later to finish whatever needs her and Susan both to finish whatever needs to be finished. So it’s not ideal that we do it after five, but just in case it makes sense for us to extend that deadline out.
James Donachie (05:35) Yep. Yeah. And it’s also like even I’m in Colorado that’d be three first if we’re supporting someone like I’m like, I think it just needs to be later. Yeah, or like I’m like, I don’t know exactly. I haven’t gotten the exact time but I just put it for midnight on the east coast because I figured at that point, it’s probably covered. I’m like and the ticket hasn’t been rejected yet, which makes me think it might not have been, yeah.
Adam Pollick (06:08) Oh, sorry, James, Debbie, what were the two criteria there? It was, the status of the provider was the credentialing was expired yet there was a credentialing date in the field.
Debbie Argentine (06:22) Yeah. So twofold, there, there are some instances where we missed the cutoff… but we got the provider so well, actually we missed the five o’clock deadline. And so once you miss the five o’clock deadline, it pushes the provider in medallion into an archive status even though we actually meet the deadline. We credentialed them before the cutoff right? And I think there were others that we credentialed them a day late like the day after. And so they didn’t make the, those are probably, I don’t think we’re going to be able to change those, but.
Adam Pollick (07:02) That one, that scenario is where it’s actually the next day. Yes. But the first scenario was same day, yes, that’s correct. It was done in time but it’s not reflected as such. So they get moved to archive.
Debbie Argentine (07:16) That’s right? And then when you pull it out on a report, so when you look at the provider summary report, it could show expired. If the provider was originally credentialed in the platform, it’ll show expired or it could show uncredentialed but they have an active valid date there. So it just makes Becky’s in the waiting room, James. Oh, it just makes reports a little bit trickier too because now you’re looking to make sure the providers, you know, actually, you know, if it says expired or uncredentialed, then you’ve got to look to see if the provider really is credentialed. So look for the date. Oh my God, I’m wordsmithing issues today. Yeah. So let me work on that James. I’ll get that list to you. I’ll work on that sometime today. Yep that.
James Donachie (08:03) Would be fantastic because then I can, I’ll go back to the team and get, that… continuing to go, the team’s still looking at, the… audit like making the audit log visible. I have that ticket open. It’s still open with the team. And then, the other one that’s still out there. I still, they’re still looking at the tin level instead of… having to do, for the providers. And now that I have the, I got the list for me after last week, I attached that to the ticket. And so I’m just going to follow up on that one as well. So those were, when was that?
Adam Pollick (08:48) James, that last ticket?
James Donachie (08:50) The, I don’t know well now, I’m getting caught up basically instead of you said the tin level, yeah. Yeah, instead of like a per provider updates, which like we have sent over for changes, Debbie was asking if we could do it on the tin level. Yeah. And she sent over an example of one of those like tins like how it would appear. And so I’m just checking with the team to see if we’re able to make, that adjustment.
Debbie Argentine (09:26) So right now, Adam, this is for opt. Outs. So when a payer, a provider opts into out of a plan in or out of a plan… medallion only has the ability to be able to do it at the provider level. But the issue we were running into which is a lot of work for us because, we have to do opt outs for each provider if we don’t have one already. But the bigger issue was that providers were all over the place. They were selecting whatever they wanted to select instead of it being all in or out at, you know, for.
Adam Pollick (09:55) Right. Yeah. The whole.
Debbie Argentine (09:56) yeah. So it’s causing massive issues like integrated medical that’s only opted in for anthem. They’re all over the place, dobbs ferry all over the place because that’s how the opt outs are. So working through cleaning some of that up. And then we’ve taken the power away from providers. So, we no longer collect those opt outs at the provider level. It’s at the tin level. Now, that means I got a whole bunch of work to do because I have to take the tin level look in medallion, see all of the providers, that are linked to that tin and do an opt out form for them. So doing it just at the tin level means I don’t have to do any of that manual work anymore. And it’s less work on medallion’s side too. That’s less for them to that they have to ingest, right? That’ll be a huge get James that’ll be, I might love you forever.
James Donachie (10:44) I, yeah. Now, I’m going to keep, I’m going to keep looking. I’m going to keep pushing that one as well. I know as you guys know, product our product team is always busy. They got, they got an army of me’s coming up to them at any given point of the day asking for different stuff, but I’m going to see if I can, we can keep working that one. So it’s on, my radar. And then Debbie, the last one I had on my list of just like things I want to make sure that we talked about was the email you sent yesterday about, the provider… the.
Debbie Argentine (11:28) Expiration date the.
James Donachie (11:29) Expiration dates? Yes. So I got a quick answer which I wrote back to you from the team as to why we send those out but I just wanted to get it. Did that make sense? I know it doesn’t like necessarily like apply to you guys. You guys look at it on a month basis, but for compliance technically like the day… I could pull that up too, and.
Debbie Argentine (11:56) I apologize. I need to include Adam and Becky on these going forward too. So let me just loop… you guys into that.
Debbie Argentine (12:15) I’m going to share my email with you. I know how much you love emails.
Debbie Argentine (12:28) So, this issue is that we get notification emails from medallion that says, hey, your providers are expired, but it’s the middle of the month and so they’re not technically expired. So it just causes confusion.
James Donachie (12:45) And let me, it looks like you just shared it, but.
James Donachie (12:55) So, Debbie gets this email… the gigantic logo. I don’t know why the logo?
Debbie Argentine (13:04) I don’t know.
James Donachie (13:07) It sounds like this needs to go to our marketing team for also. But then it will give the expiring provider. And so, for example, there’s these providers, the way that you guys look at it is, you have till the end of this month to get this provider back. So to wrap this up, what I have heard from our compliance team. And this is what I wrote back to Debbie is regarding the notification, medallion system triggers these alerts based on specific dates to maintain the ncqa credentialing accreditation compliance. While ncqa counts the 36 month recredentialing cycle to the month, they require precise documentation of decision dates for audit integrity.
James Donachie (13:56) And so this is why we have to like why they don’t just have April 20 26 and they include the date. And then they cited CR six element a, that was not me. I got that from someone.
Debbie Argentine (14:10) Yeah. I know what that is.
James Donachie (14:11) Yeah, but I think that’s like the language of which they, our compliance team was basing it off of. And then because ncqa prohibits falsifying dates, we must use the original decision date down to the day. All right?
Debbie Argentine (14:25) No, that makes perfect sense to me as long as it doesn’t actually expire, we’ll just disregard those.
James Donachie (14:30) Okay.
Debbie Argentine (14:32) Thank you for that. So, can you scroll back up now? I see two. Now, I have two different, two additional questions. Okay? There are two providers there, Bobby, chanduk?
James Donachie (14:41) Okay. That.
Debbie Argentine (14:42) He’s deactivated. So I don’t know why he’s pulling.
James Donachie (14:48) Let’s let’s take a look and then.
Debbie Argentine (14:49) the other one is dr patshta.
James Donachie (14:55) Let’s see.
Debbie Argentine (15:00) I’m trying to get ahead of Adam. We have a lot of terms in the, that he’s terming through the system. And I’m trying to get ahead of him because it helps medallion too. So if I can get these guys termed before they start their recredentialing cycle, that avoids a cost. There’s a cost to doing all that and it just avoids work. So, I can’t seem to get catch up… slow down, Adam.
Adam Pollick (15:25) Let’s yeah, I know I gave you a heads up today with the park care one because I knew once they were done there, will there’d be a chunk, probably right? Like just the law of large numbers, whatever it’s a large group. They’re likely going to give a bunch.
James Donachie (15:42) This is so slow all the time. All right. Let’s take a, so.
Debbie Argentine (15:47) Chandok CH a ND o K was the first one. Hi, Becky, boo… hey.
Adam Pollick (15:57) Hi, Rebecca Lewis. Oh,
Debbie Argentine (15:59) geez Adam, you know what’s going?
Adam Pollick (16:01) On I,
Debbie Argentine (16:03) didn’t do anything wrong?
Adam Pollick (16:04) I’m right. Yeah, it was the middle. Hello, Adam, Charles.
James Donachie (16:13) Chandok, the.
Debbie Argentine (16:13) Terminator, the.
Adam Pollick (16:16) Terminator, you know, it’s like the dues process shakes all that loose. I guess.
James Donachie (16:20) I love it.
Adam Pollick (16:22) It’s amazing. So.
James Donachie (16:25) It looks like he’s cleared out and there’s not a file here. Debbie. Yeah.
Debbie Argentine (16:29) I wonder why he’s hitting that list.
James Donachie (16:32) Yeah, I wonder. And when did this email come from? Was there? Oh, no, April? Yeah. The.
Debbie Argentine (16:37) Monday.
Adam Pollick (16:38) Oh, boy. Look at that. I recognize providers on there. Yeah.
Debbie Argentine (16:42) And he was termed a while ago, too. So was the other one, dr patchka, dr.
Adam Pollick (16:50) Patel is expired… is he?
Debbie Argentine (16:58) Patchka is, let’s see. He’s.
James Donachie (17:01) probably not patchka’s.
Debbie Argentine (17:02) termed.
James Donachie (17:07) I’m going to guess that there was a delay on. When do we think that you guys, did you guys, maybe no, he was termed? You’re saying before?
James Donachie (17:21) Yeah.
Debbie Argentine (17:22) Chanduk and patchka have been deactivated for a while?
Adam Pollick (17:26) I’m.
Debbie Argentine (17:26) not sure about, I don’t think I did anything with Patel Mitul Patel?
Adam Pollick (17:31) What does that say? I can’t even see?
James Donachie (17:34) Let’s see.
Debbie Argentine (17:37) Yeah, he’s still active. I don’t think he’s on a term. I don’t think Adam?
Adam Pollick (17:41) Yeah.
Adam Pollick (17:42) No, that was one that I kind of had a fair amount of engagement with and just actually sent a dues invoice this morning that’s what I was like. All right.
Debbie Argentine (17:53) As long as they’re not there’s no active work being done on medallion’s side? There’s no cost being incurred or the providers on that list aren’t really expired. I’m good with it. We’ll just we’ll just,
James Donachie (18:05) yeah, I want to, I’m curious as to how they got there. It doesn’t look like any work’s being done. It does look like Patel… looks like he signed his. He went back in and re signed his agreement. So this one, should be going, yeah.
Debbie Argentine (18:23) He’s not a term.
James Donachie (18:24) Okay. So it looks like the ones that are not termed are getting worked and the ones that aren’t I’m… more just kind of curious about that. All right. My own, as to how that happened. Okay?
James Donachie (18:44) And then, those were, my updates all.
Debbie Argentine (18:50) Right. I have a couple. Okay. Any update on the team manager access and the, that functionality that we were trying to work in parallel with rolling out the new team manager access role?
James Donachie (19:05) Yes. Did Steph… if you got, did she not write back when like when the, with the QBR, I thought she was going to write something to this group.
Debbie Argentine (19:17) Let’s see maybe I missed it and.
James Donachie (19:20) If not, I can, after this call, I can go and ask her for the like the verbiage on that… one. But.
James Donachie (19:40) Anything? Okay? Let me, I know she’s she was working on your guys’s I think it’s the… well, I guess this is a good thing to just double check and I can make sure with her. Great. So.
Debbie Argentine (19:58) In process.
James Donachie (20:03) So, April, our April 20 ninth, Wednesday, which we’re we’ll meet in the morning, which I guess we can decide the week before we want to meet, if we want to have a double meeting… and it’s at… two o’clock on the east coast. All right. You guys, everyone, let me make sure that everyone is on this. I see Adam. I see Debbie, I don’t see Becky.
Debbie Argentine (20:34) Yeah. Can we add Becky?
James Donachie (20:35) Yeah. Let me, I’m going to, I have the power to do that. So this is good. I.
Debbie Argentine (20:41) Love that power. Okay. Yeah.
James Donachie (20:46) I see Michael. Okay. Anyone else from your guys’ side that should be on here?
Debbie Argentine (20:53) No, I think you got us.
James Donachie (20:54) All right. We got the team. All right. Perfect.
Debbie Argentine (20:57) Okay. Next thing, the par ingestion file. So I actually did go through it and I’ve made 8,500 updates to addresses. Mike wants me before we send that back to you guys. Mike wants me to verify and it’s a good point. Wants me to verify with the plans that we selected to update. So that was the Aetna blue cross and blue shield health plus, unitedhealthcare and emblem and health first, just to make sure that those updates that I made had no, will have no impact to billing some of our plans and that’s health plus and health first. So some of our plans look at practice locations and their system is configured that a provider has to be par in a specific location in order for a payment to drop. So he wants me to make sure first that there’s going to be no impact. So I believe he wanted to try to roll forward with everything… else that had a match based… off those certain data points. But I think you guys said you already did that and you were going to confirm?
James Donachie (22:15) So,
Debbie Argentine (22:16) I think you pushed forward everything that matched based off of like the provider mpi, the tin address, one, address two. I thought you said in the last meeting that those you were working on ingesting these that you sent back to me were the issues?
James Donachie (22:33) Yep. Yeah, exactly. I only sent you the… because I’m going to use general numbers because I don’t remember the specific lines, but it was like 50,000 rows the, on the original file and we were able to ingest around 8,000 of those. And I believe the file I sent back to you had like was around 42,000 rows. And those were, the errors. So do we?
Debbie Argentine (23:07) Have time we have until 1,145, right? Yep. Okay. So if I go to your file, so the file that you sent back to me had everybody on it, right? Or did it just have issues?
James Donachie (23:20) It just had issues.
Debbie Argentine (23:21) Okay. Can we get, and I think you were working on it? Can we get, can we get a file that shows all of those that were ingested? I want to go and look in medallion and confirm that we’re seeing some par dates?
James Donachie (23:33) Okay. Let me, yeah. So do you want, do you want just a… I wonder if, well, yeah, if we made the one file? Yes. Yeah, I think so. I’m gonna, there has to be a way, to slice this because if we made the file with just errors, that means that there.
Debbie Argentine (23:54) There hypothetically.
James Donachie (23:56) Is a just right file out there? Okay. Yes. Let me, let me track that down. That makes sense.
James Donachie (24:06) It also sounds great. I think that’s a really good step that you guys are taking with the payers because if there’s one thing, I hate it’s solving one problem, but then we’re creating a problem for you elsewhere, yes.
Debbie Argentine (24:20) For sure for sure. And we also want to make sure the payers have the correct address loaded because I’m not going through that file again.
James Donachie (24:28) Yes. Yeah, that is, yeah, that’s a great call out.
Debbie Argentine (24:32) Okay, perfect. So, I’ll let Mike know that we did well. I’ll wait for you to send me the file. Okay? We talked about archived, we talked about the audit log.
Debbie Argentine (24:49) I don’t think I had anything else.
Debbie Argentine (24:56) Oh, hold on. I’m in the wrong month. I mean, in the wrong day, team manager, par, ingestion audit log, effective dates group. No, I think that’s everything I have. Okay? And.
James Donachie (25:07) also, so, I’m gonna get with Jim. I’m gonna try to get those completions because that’s something I should do quickly. I know we have those product tickets out there. I wish I managed them, but I don’t because then, I would selfishly have them do all the things that I need for my book. Could you?
Adam Pollick (25:25) Could you open a ticket for that to manage tickets that you have?
James Donachie (25:30) Yeah. I should do that. That’s that’s what I’m missing. But that, and then I will also, I will also ping Steph again for, the team manager. I know that she’s been working really closely with our like product team. I think we’re going to have some product leadership join… the, our like our QBR too to kind of give, some updates. So that would be really good for you guys to meet. Yeah.
Adam Pollick (26:06) That’s the April 20 ninth meeting we were.
James Donachie (26:08) Talking about earlier. Yeah, the April 20 ninth meeting, yeah.
Adam Pollick (26:11) Stephanie had been initially sending that email, right?
James Donachie (26:13) Yeah. So the, and the team manager is kind of like she’s been kind of working, on part of that. So to make it less messy and me, like I didn’t want to like partially communicate, she was like owning the communication cause I know that was something that happened before I came onto the account and, she was already working. So I’ll just get an update from her on that.
Debbie Argentine (26:36) All right, Adam, Becky, anything? Nope. I think that’s good.
James Donachie (26:44) Awesome. Well, I will keep plugging away and then Debbie, whenever you get those archives. I like, I also think we’re going about that the right way. I’d rather get them all and it take you till Friday. And then I send it okay only because when I have the, our product, you know, the product, the right person’s attention. Like, I like to just get them to do it all at once. So then I don’t go like a week later and they.
Debbie Argentine (27:12) Oh, yeah. Here’s more and.
James Donachie (27:14) they forget about me. I’m old news but, you know, my thing, you know. So, so I like our strategy. Yeah, we’ll wait a couple of days and just get it. We’ll do everything at once, and that’ll be the way to go.
Debbie Argentine (27:26) All right, terrific all.
Adam Pollick (27:29) Right. Thank you, James. Bye.
James Donachie (27:30) Everyone. Bye.