Transcript
Vanessa Persha (00:00) hi, Stacey. Good afternoon.
Stacy Cloyd (00:10) Sorry, I was talking on mute.
Vanessa Persha (00:12) Oh, you’re fine. I’m doing well. Thanks. How are you? Good. Are we waiting on anybody else to join today? I know Leslie said she wasn’t going to make it today. Yeah, I think.
Stacy Cloyd (00:25) Carrie and Mandy are joining.
Vanessa Persha (00:27) Okay.
Stacy Cloyd (00:49) Just one second.
Vanessa Persha (00:50) No worries.
Stacy Cloyd (01:02) We just got out of another meeting. So, I’m guessing that everyone’s actually… Carrie may not be on because I think she was jumping on a different one. Okay? I’m not positive on that. Okay? I.
Vanessa Persha (01:17) really? Don’t have a whole lot of updates today, other than just sharing that the par analysis lines that you all submitted are moving.
Vanessa Persha (01:24) We’ve completed 39 of them already and 119 are still in process. And then it looks like there’s 14 in needs client attention. So, the payer may have been looking for some additional information to complete the par analysis or we may have needed something to respond to the payer?
Stacy Cloyd (01:47) Can you take a look at those?
Vanessa Persha (01:48) Sure. Let me pull up your needs, client attention lines here.
Vanessa Persha (01:59) Looks like these are mostly for lucid provider… portal.
Vanessa Persha (02:09) So, it looks like for lucid, we were advised that the provider status needs to be checked via the portal. Do you guys already have a portal created? Okay? I don’t know how lucid’s portal works.
Stacy Cloyd (02:25) Is that one that you can’t follow up on?
Vanessa Persha (02:30) Essentially, they’re saying in order to follow up, we just need to look into the portal. So we either would need like a, to create a portal like a medallion portal that you link us to the optum account, or if you can share logins to the optum account, we would just need that so we can log in and check.
Stacy Cloyd (02:53) Are they all lucet the port team? It?
Vanessa Persha (02:56) Looks like it, let me go to the yep. They are all lucet?
Stacy Cloyd (03:12) Okay. And I don’t know that if… you guys don’t have your own portal, I don’t know that we’re all we will add because we don’t have very many. It’s only four teams. Yeah. So let me take that back. Okay?
Vanessa Persha (03:33) And I’m going to check our payr directory right now just to see if we, what… our portal website process is here. Give me one second.
Vanessa Persha (03:53) Yeah, that’s weird. We have that our follow up process is to email providersupport at lucidhealth. Com. But then they’re redirecting us.
Vanessa Persha (04:10) it looks like… so for individual providers, they have their own login but let me go see what’s at the group level here. Oh, Mandy’s trying to join. Let me add her in. Yeah, the group. It looks like groups and providers can have their own logins for… the lucid portal. Hey, Mandy.
Mandy (04:42) Hi, sorry, I’m late.
Vanessa Persha (04:44) Oh, you’re fine. I was just telling Stacey, I don’t really have a whole lot of updates for you guys today. Just the we’re looking at the par analysis lines. We were able to complete 39 of those 14 are in needs client attention, and those are all for lucid, which we’ve tasked out for portal access. The payer is redirecting us to the portal. Is that something you guys have a… group login for that you would share with us? Or how do you guys want us to?
Stacy Cloyd (05:23) That’s what I’m saying is.
Vanessa Persha (05:24) If it’s.
Stacy Cloyd (05:26) a portal that you don’t have access to… that we didn’t know about originally, then I guess we’ll have to remove those 14.
Vanessa Persha (05:35) Okay. Let me go, make sure what state is that for? Because I thought that.
Stacy Cloyd (05:40) Was one that was on the list that you could do. Oh, I mean, yeah.
Vanessa Persha (05:48) I mean, we can certainly do them, but the, like I said, the payr is redirecting us back there, which I mean, normally, for customers that have portal access, they grant us access to the portal, so we can continue to follow up. But if you’re saying you don’t want to grant access or the juice isn’t worth the squeeze for the 14 lines, then yeah, or 14. I’m just looking at your payr… project plan to see if there was ever any portal stuff given to us here. It does logins.
Stacy Cloyd (06:25) And then I have some questions.
Stacy Cloyd (06:35) To ask about, just let me know when you are ready.
Vanessa Persha (06:41) For.
Stacy Cloyd (06:42) more, if we can give you a few more, but I want to ask some follow up questions first. Okay? Do you guys have access to blue cross blue shield, Nebraska? Let’s see.
Mandy (07:04) That goes through a portal.
Vanessa Persha (07:06) It.
Mandy (07:07) goes through navinet. Stacey.
Stacy Cloyd (07:15) For enrollments?
Stacy Cloyd (07:23) I think not follow ups but enrollments follow ups?
Mandy (07:27) Are definitely navinet. I feel like it’s a roster but I can’t remember off the top of my head because I haven’t done one in a while.
Vanessa Persha (07:35) I’m pulling up what our process is here. Give me one second. You’re asking for enrollment specifically, right? Stacey. Okay. Let me look and see. I.
Stacy Cloyd (07:47) Have a few that I’ll ask for enrollments, and then a few for follow ups, but we’ll start with enrollments. Okay?
Vanessa Persha (07:54) So, the process that you guys provided to us forever ago when we implemented you for blue cross blue shield, Nebraska is to complete the PDF application and submit to credentialing requests at nebraskablue. Com. Is that still your same process?
Vanessa Persha (08:19) I’ll have to check. I’m going to have to look, I can’t remember.
Stacy Cloyd (08:23) Okay. So, you don’t have anything other than what we gave? I.
Vanessa Persha (08:27) mean, we have our like a payer directory that we would follow if like that’s, typically the standard process. But anytime a customer gives us like specific instructions, we go off of the instructions that you provide to us.
Stacy Cloyd (08:45) Do you have stuff for Nebraska already for vcbs Nebraska?
Vanessa Persha (08:50) Our own internal process? Huh. Yeah. Give me one second. Let me take a look.
Vanessa Persha (09:04) So they don’t have,
Vanessa Persha (09:19) it’s the same process. It’s the credentialing form and you submit it to that email address there. I do have noted on here though that behavioral health is out of scope for this payer. Are they processed through a different payer for behavioral health?
Stacy Cloyd (09:42) We’ll have to look into that. I’ll take that one off of our list for now. What about regions, blue shield, Oregon?
Vanessa Persha (09:59) So… you guys did not give us instructions for that. Let me go look and see what our standard process is, because that’s what our team would be following. What was the state Oregon?
Stacy Cloyd (10:13) Oregon regions?
Vanessa Persha (10:18) So, we do have a standard process there for Oregon. Let’s see… if provider is in scope.
Vanessa Persha (10:37) Yeah. So, it looks like if the provider requires credentialing, we submit for credentialing first. Once credentialing is complete, we go to the provider contact center and complete a provider information update form to link them to the group. So, we do have a standard process there, and that’s what we would be following for any of your enrollments since there’s no special instructions from you on the project plan. Okay? Moda. Hello?
Vanessa Persha (11:20) Let’s have us following our standard process there as well. Let me take a look at moda’s.
Vanessa Persha (11:37) I don’t have a specific process for behavioral health on them just for medical. But it’s just sending providers, first name, last name and caqh id to credentialing at modahealth. Com.
Stacy Cloyd (12:13) Melina, Nebraska.
Vanessa Persha (12:23) We would be using our process for that. Let me go look at that one.
Vanessa Persha (12:48) So it looks like we send a provider information update form to anycontracting at melinahealthcare, com, and that’s for the behavioral health process.
Vanessa Persha (13:02) And we do require providers to be, or they require providers to be enrolled with traditional medicaid first since it’s just a managed medicaid product.
Stacy Cloyd (13:16) Partners, direct health?
Vanessa Persha (13:22) Do you have a particular state for that one?
Vanessa Persha (13:53) The nationwide plan? I was just, I wanted to check and see if you guys gave us California. Yes.
Vanessa Persha (14:23) So, we do not have special enrollment instructions for you and our payer directory excludes behavioral health. So we likely would not, we would either need special instructions from you or to review this internally.
Stacy Cloyd (14:45) Okay. University health alliance.
Vanessa Persha (15:07) Is that in Hawaii?
Vanessa Persha (15:18) So we would use our process?
Vanessa Persha (15:34) I do not have a defined payer process for them. What for, uha, no?
Vanessa Persha (15:46) Looks like somebody internally started defining the process, but it’s not complete. So I would not feel confident moving forward with that unless you guys gave us instructions.
Stacy Cloyd (15:57) Okay. The next question is on follow ups. Okay? Do you follow up differently on plans on payers that are delegated versus non delegated? Yes. So, have you ever followed up on any delegations for clients?
Vanessa Persha (16:18) Yes. However, I believe you have to have delegation included in your contract for us to do follow up on delegated agreements?
Vanessa Persha (16:32) I can double check with Molly to confirm, but there’s like specific skews for delegation that have to be in your contract for that.
Stacy Cloyd (16:50) Do we have that I?
Vanessa Persha (16:52) Don’t believe you. Do. Let me ping Molly really quickly though, just to see.
Vanessa Persha (17:40) I sent a ping out to her. We’ll see if she’s able to respond.
Stacy Cloyd (18:05) Okay. Who said she is responding or? Yep.
Vanessa Persha (18:17) She’s messaging. She’s asking for some clarification. So it would be for essentially we’re following up with delegated payers for enrollments that you already submitted? Yep… that’s correct? Okay. She’s checking on that.
Vanessa Persha (18:47) Did you have another question? We can move on to while she’s looking into that? No, that was the last one. Okay. Yeah. Let me see. She’s going to check into that. We can give her another minute or two. And then if she doesn’t respond, I can always follow up via email for your lucid lines. Do you want me to just move those into stopped then?
Stacy Cloyd (19:08) Yes, please. Just for those four came back saying, now, what about the 119 that are still in process?
Vanessa Persha (19:16) Yep. So let’s take a look there. Most of them. The payers provide full rosters for. So we’re just pending a response from the payer on the roster so we can validate against that. Couple other ones we’ve confirmed enrollment and we’re just following up for the provider id and effective dates.
Stacy Cloyd (19:43) How often do you guys follow up on those for like the ones that you’re waiting on a roster or the approval or anything like that?
Vanessa Persha (19:49) So, we do every two weeks once we’ve actually made contact with the payer. So, if we haven’t made contact, we’ll continue to follow up until we’ve actually received a response. And then once we get a response back, it’s every two weeks… it looks like the agent is having a hard time getting in touch with somebody from MVP health.
Vanessa Persha (20:18) They did send an email to a rep because they’ve been calling and they’re not accepting calls. So we’re pending a response from an email.
Vanessa Persha (20:36) Do you have the email for?
Stacy Cloyd (20:37) MVP it?
Vanessa Persha (20:39) Looks like we emailed a specific rep, ebanky at MVP health. I wonder if that’s your rep listed in your project plan?
Vanessa Persha (21:00) MVP is New York, isn’t it?
Stacy Cloyd (21:04) Yeah. I don’t think we gave any rep names because I think you gave us the payers that you knew, those are the only ones that we included on the list.
Vanessa Persha (21:43) I don’t see in your project plan that we have a specific rep to reach out to for MVP. So I’ll have to check with her and see where she pulled that contact from.
Stacy Cloyd (21:54) And when was the last connection there?
Vanessa Persha (21:59) Looks like, and is that like daily?
Stacy Cloyd (22:04) Weekly?
Vanessa Persha (22:10) I need to ask her to attach her email to the lines because she doesn’t have them attached right now. The last note she made was on 419 that she’s made multiple attempts to call and has now sent an email.
Stacy Cloyd (22:25) 419.
Vanessa Persha (22:27) Four nine was the last. Sorry, I’m like we’re not even there yet. We’re not, I.
Stacy Cloyd (22:36) Was like 319? Maybe, yeah…
Stacy Cloyd (22:54) Okay. That is all I had.
Vanessa Persha (23:08) Doesn’t look like Molly has gotten back to me just yet, so I can circle back with you guys via email, okay?
Vanessa Persha (23:25) Yeah. So we’ll, I guess we’ll just touch base again in two weeks. If you have any questions or want to follow up on anything you’re seeing for the par analysis lines in between now, and then just let me know. I’ll go ahead and stop those lucid lines and then get back to you when I have an update from Molly on the delegated follow ups. Okay. All right. Awesome. Sounds good. Well, thank you, ladies. Appreciate your time. Take care. Thank you. Bye bye. Thanks. Bye bye.