Transcript
Brandon Bradshaw (00:00) hello? Hey, Jackie. Can you hear me? I?
Jakelin Patino (00:01) Can hear you, Brent. Can you hear me?
Brandon Bradshaw (00:03) I can. How are you today? I,
Jakelin Patino (00:05) am good. How are you? I’m.
Brandon Bradshaw (00:07) doing all right. My ex, unfortunately came down with, well, my whole family did with that cold starting pretty much shortly after our call on Monday. So, I have just kind of been jumping on when I can and resting when I can. So I still owe you guys an email and some follow up information. So I apologize for that.
Jakelin Patino (00:24) No worries. Hope you feel better soon.
Brandon Bradshaw (00:27) Thank you. Hey, Naomi. Thank you for hopping on. I think we got Amy here and that’s it.
Jakelin Patino (00:36) Yeah, she’s joining right now.
Brandon Bradshaw (00:43) I think Kathy accepted, but I don’t see. I haven’t seen her in here yet, but I think it was mainly the two of you that was most important to be on this correct?
Naomi Denson (00:52) Correct. Okay.
Jakelin Patino (00:54) Mostly Jackie, not me.
Brandon Bradshaw (01:02) So, I’m going to go ahead.
Brandon Bradshaw (01:03) I’ll share my screen and just pull up the data import template here. Unless there was anything you wanted to show first or had any questions just right off the bat, Jackie.
Jakelin Patino (01:11) I can definitely share the template you guys had shared with us and then show you what I have so far? Sure. Perfect. Okay.
Jakelin Patino (01:30) Like,
Jakelin Patino (01:41) do you see… my screen or? No… I see yourself.
Brandon Bradshaw (01:51) I see zoom.
Jakelin Patino (01:53) Can we try this again?
Jakelin Patino (01:59) There’s no reason it’s not letting me pick the… entire screen. It’s only going to just the zoom.
Brandon Bradshaw (02:15) I think as you’re on the tab, are you able to click over to your other tabs at the top or do you have a?
Jakelin Patino (02:21) No, perfect. Perfect. Yep. All right. Okay. Do that first time. Okay. So from the tabs you guys have given me, I was able to send over to Kathy and her team, the provider enrollment parts just because that’s what her team mainly focus on. So that on my end, I will have no questions. I’ll be more for her to answer. However, the first six tabs is what I have been working on. So obviously you let me know if I’m missing anything or if anything should be in a different format, I guess. But the first tab obviously is pretty standard. So it was very simple to get that in going. I just have a few things missing which I’m waiting on responses from other departments to verify. And then as I move on to the group profiles, this is where I kind of had a little question just based on our conversation yesterday. I don’t know if you guys wanted this part just to be our profit center, like our care centers or if you wanted this to be strictly just the main hub of redefine healthcare?
Brandon Bradshaw (03:32) I’m just taking a look.
Naomi Denson (03:39) Yeah. So all of these group profiles have the same tax id, the same npi, the name that you used are those dba names? Yes?
Naomi Denson (03:57) Yeah. So we would want to… we typically like to see unique names here, but… there is a column to the right that is for dba names. Is that?
Jakelin Patino (04:14) On this one, I know one of the tabs has it, not all of the tabs, do I just forgot what the?
Naomi Denson (04:19) Group profiles and the practices should I?
Jakelin Patino (04:22) Think that is the one that has dba? No?
Naomi Denson (04:26) The groups does, can you go back to the group profiles tab and do control F… and dba. I just can’t remember exactly there it is.
Jakelin Patino (04:39) Okay. Far to the right.
Naomi Denson (04:43) Yeah. The only thing is, so typically we like the legal entity name and the group name, and then you have the dba column here, but.
Jakelin Patino (04:52) When… you’re in the.
Naomi Denson (04:56) platform, like if you were to go to a provider’s profile and want to associate them to a new practice location. It’s going to make you select the group first, and you’re only going to see that legal entity name. So typically, what we recommend as you can see in that row six on the name column back at the beginning, it says unique names recommended. So you could put the legal entity name with like a code like if you have any like practice codes or like an abbreviation of the dba or something like that just to set it apart. So, you know, which one is which?
Jakelin Patino (05:31) So, for instance, it’ll be redefine healthcare. And well, premier brain is fine. The legal name that’s under the tin is premier brain is fine LLC. And it’s followed by all the dbas. Redefine healthcare is our, was our original primary and is our primary branded name. So, for instance, if one were to go to one of the other locations and you would see the dba banner name on their door, that is should also say, you know, xyz office, a division of redefine healthcare, even though the legal entity name is premier brain and spine LLC, that officially is the dba for the entire tin, technically that we use is redefine healthcare, for instance, like if you were to go to our website, it’s the redefine healthcare website. But when we fill things out, all the government, certainly, when I’m doing like medicare stuff, it’s always premier brain and spine LLC. And then it’s the, and when we include the dba, it’s what is currently in column D for me here. So those are all dbas. So the dba goes in column ag, Aj, ag, whichever it was. Then all of these in column D would all be premier brain and spine LLC, because that is what matches the tin.
Naomi Denson (07:01) What is on? Do you have separate W nines for each one?
Jakelin Patino (07:05) There’s only one W9. We’re only one entity. The rest.
Naomi Denson (07:09) Of you don’t have separate W nines with the dbas on them, and separate tax letters. And.
Jakelin Patino (07:14) No. If we needed for something comes up where we needed to show that, then we can get it as needed because we are dba, all of them. So I can produce one when and where needed.
Naomi Denson (07:28) So, when you submit enrollments now with, the redefined entity name, and they ask you to provide a W9, you just send the one that has the LLC name on it, no dbas or anything. And then you list this name here that’s in column D as like the practice location name?
Jakelin Patino (07:47) I can’t answer that question because I’m not the one submitting it. I’d have to go back to focusone or Cathay to find out.
Naomi Denson (07:53) Yeah, because if there’s only one W9, you don’t have separate W nines separate. I.
Jakelin Patino (07:59) Mean, normally, they something like that, if they need it signed, they usually come to me. Hey, can you get me one of these? I need to sign such and they do not come to me for each of them. Now, it could be that they were doing it for something else needed in finance. So they had one and they got it from them. But I don’t want to answer that question because I have to find out exactly how they’re submitting it. I can only say what is accurate, which is what I just said before. Yeah.
Naomi Denson (08:23) If we can confirm that because if it is truly only one W9, there’s not separate W nines. And like CP 575, 147 C tax letters for each individual dba?
Jakelin Patino (08:36) There’s no, there’s no separate tax letters.
Naomi Denson (08:38) Okay. Then we can window this down to one group profile. And then each of these would be the practice location. Because if we keep it like this and there’s not truly any differentiation and documents or like submission processes then I don’t know exactly how many you have listed here, but that’s a separate group profile that has to be maintained.
Jakelin Patino (09:00) Yeah, I’ll double check it. But in reality, because we’re all under the same singleton, there are, there is no breakout other than for our internal purposes. So the only time that the primary reason that we did all the dbas is because internally, we need to distinguish for, primarily for expenses, but for other tracking reasons of the different centers and how they’re doing stuff. We just, you know, kept that as separate divisions to departmentalize them. They’re really more departments in a way, the.
Naomi Denson (09:35) service locations under the practices, but.
Jakelin Patino (09:39) But the service locations gets to the next part because we have some locations that more than one of our groups, you know, may use or, you know, a couple of the providers, one or two providers from this group, all of the providers in that group or, you know, there’s a division that says, all right, this is their original main office, but they have room on certain days and somebody else from one of the other groups, but still all of them part of us. We want one of the other specialties to go there, then we just that a location is added for them. So it may be a, an additional location for a, for an existing provider… but not necessarily associated to.
Naomi Denson (10:24) Multiple practice locations in the profile, but they only really need to be tied to one group since they’re all, there are.
Jakelin Patino (10:34) that’s just.
Naomi Denson (10:34) me go.
Jakelin Patino (10:35) Ahead. All right. Can.
Naomi Denson (10:38) I see the practices tab? Yep?
Jakelin Patino (10:41) That was my next question because this is how I had started it, but obviously I will change it if I have to don’t mind the coloring that shows like a neat bird through my verification.
Naomi Denson (10:50) So, I see all of the, okay. So I see all of the individual practices with separate addresses with the same name like AJG spine.
Jakelin Patino (11:02) So,
Naomi Denson (11:02) do you have AJG spine… linked on? Like, is that one group that you currently have on the other tab? Yes, you have it listed as one group AJG spine. And then the practice locations, can we go back to the practices tab really quick? Sure. And they all have the same npi. There are no individual… correct?
Jakelin Patino (11:30) They’re all the same. And so on this one, you’ll see obviously, there are going to be a lot of repeat addresses because more than one subgroup or division has providers that are going there. If we stick with AJG by way of example, the hackensack? Okay. So 146, north state route 17, 2,500 Morris avenue, 10 farsonage road. Those three middle ones, that group goes on a couple of days a month to one of the other locations, but those are part of our core group locations. So if you were to scroll down, please to our core read of my healthcare group… you’ll see those addresses in there. Again. There’s actually two of them for 10 farsonage, because we have several different suites there. There’s that same 146 north state route 17. There’s the 2,500 Morris avenue. So that’s an example where you’re going to see repeat locations, but it’s all us. And the reason that they’re repeated it’s because this is grouped by division. But every division, every location is all under the same singular tin for premier brain and spine.
Naomi Denson (12:43) Okay. My only concern with this initially is that there’s 102, 103 separate practice locations with a lot of duplicate practice addresses.
Jakelin Patino (12:58) Now, when we get into.
Naomi Denson (13:00) the system and go live, that’s not going to be 100 plus separate practice profiles that have to be maintained and differentiated against. How does this? I know that it’s like different for like scheduling and division wise. But how does this differ when you build?
Jakelin Patino (13:19) Let me ask if I may, let me ask a question that is Jackie probably knows the answer but I don’t because I haven’t done this part of it when the applications are submitted and you say what the different locations are now over time, you know, even in our scheduling, for instance, we can say, hey, dr, so, and so is going to start going to this other location, right? A location that was not let’s say on their initial application, but there’s a reason that we have internally that we want that doctor to go to a different office. Is there something somewhere that has to be done that says this doctor is now going here and we have to, I’ll use the word file loosely because it’s April and we have to file that someplace somewhere. So the provider is working at some.
Naomi Denson (14:08) Locations and you decide, you know, they’re now going to start also going to this other location, you would just add the practice association in the platform to that provider’s profile. And if it needs to be updated with a payer, there’s an option to do a demographic update request to officially add that location onto the provider’s enrollment record with the payer, right?
Jakelin Patino (14:30) So, the question becomes, you know, what really makes the most? Because I think our setup internal setup is different from most and therefore might need a little tweaking on the workbooks because the majority of these breakdowns that Jackie… has shown in groups under name again is internal purpose only. Yeah.
Naomi Denson (15:01) So, we want to know what the legal setup is that we would have to submit to a payer. So the payers aren’t going to acknowledge your internal setup. So that would just, I think that would be best to just be set up as one group.
Jakelin Patino (15:15) Right. So as far as the payers go, you know, they already have all our locations. The only time that changes is if we’re bringing on a new group that now adds new locations. So if we’re bringing on a new group that we are credentialing those providers, then at that time we’re adding those locations along with those providers. Generally speaking, initially, we’re not adding those locations for any of the other existing providers down the line. If that changes, we’ll do what you just described. So for the most part, it seems like the locations should just be broken down by provider. And Jackie’s shaking her head as far as they’re concerned for what they’re describing, please speak up on this because from the credentialing standpoint, no payer needs to have any separate name because we are premier brains buying dba redefined healthcare that’s part of what we call ourselves internally. So beyond that, the only thing the payer needs to know is the provider and the location, their primary location. Yes. Do we have to update satellite locations?
Naomi Denson (16:30) It depends on the payer. Okay… my recommendation is going to be to whittle the group profiles down to one profile for the tax id and the npi for the one entity. And then on the practices, we only need one entity line for each separate address. So I see there’s just for example, I see the redefined healthcare, they have three separate addresses. They’re at 10 Pasco, you wrote, but they have separate suite numbers. So those would remain separate. So if there are any true duplicates, we don’t want to create a duplicate.
Jakelin Patino (17:08) Profile, the suite numbers, of course, you know, we offer one, we need another and we need another. So, we have more than one space, but they’re all us like, in edison and I actually have, did they ask myself enough? I have another, an extension suite, but basically, those two would be correct. So if we stick with the, this page, then this would should be redone in the sense because this gives the impression that there are all these separate entity names from what I’m hearing you say and it shouldn’t be because those are just the dba. So, but… I’m not sure that this is.
Naomi Denson (17:50) how we’re requesting. So this is you’re gonna when you request an enrollment and you’re gonna say I want this provider enrolled with this group with these practice locations attached. Okay?
Jakelin Patino (18:01) When let’s just stick when you say with this group. So I just want to make sure that we’re using the word group the same way to us internally. Yes, it’s a group. You understand how we break it out as a group. But as far as a payer is concerned, it’s not a separate group, right?
Naomi Denson (18:22) Understood. So, you’re going to say, I want this provider enrolled under this group profile, this tax id, this entity. So the group profiles tab, you’re going to select the group profile. You only have one technical entity, one legal entity that your group contracts fall under. As you take on your new separate groups, they’re added to the one contract, correct?
Jakelin Patino (18:46) They’re added to the to our tenth hour to our one, right? So,
Naomi Denson (18:49) you’re not getting separate group contracts for each of these. They’re all being added to one, correct? So, you’re going to say I want them enrolled with the LLC, the premier brain and spine LLC group. That’s… how we’re referring to group as the group profile. And then it’s going to ask which practice locations do you want associated. Then you’re going to select all of those practice location addresses for, that are tied to that dba?
Jakelin Patino (19:17) One of the things though that you were saying when you’re pointing out how many rows are here and it’s only going to increase because we have there’s duplication and triplication, of many of the addresses, so.
Naomi Denson (19:30) How,
Jakelin Patino (19:32) how is there something that should be avoided or done differently? So that you only have?
Naomi Denson (19:38) Four. So because they do have some of them have the same address line one, but they all have separate suite numbers. So if you, if the providers are practicing in both and they’re all being registered with the payer? So.
Jakelin Patino (19:51) They’re not separate suite numbers. So let’s use union. As an example, 2,500 union in is suite 220. And I have that for our core redefined health care, it’s for AJG, it’s for coastal, it’s for any, it’s for growl. Anybody who is going into the union office goes to suite 220. There’s no separate anything. It is literally the same exam rooms, the same waiting room, the same, everything. Regardless of who is here. It’s just, they’re here at different times, they just share the space.
Naomi Denson (20:26) Right, right. So, I see, the 2,500 Morris avenue, suite 220 for redefined healthcare right here? Yeah. Is it on any other row? Yeah?
Jakelin Patino (20:38) Okay. So.
Naomi Denson (20:39) We need one row per address… suite number, city state combination to create one practice profile. Then the practice name, I know you guys have this separated by group, but we wouldn’t that.
Jakelin Patino (20:56) So for that, so that one, in a sense where we, you’d need that, it would be better if D, you know, KD and E and, you know, the rest of the address came before what’s listed, in name and maybe like a sub section to it. So if you want to go by address, what you’re saying is you wanted to say 2,500 Morris avenues who teach running union and then list the groups that are going there.
Naomi Denson (21:23) Yeah. So you, we just you, we just need each in individual address to have it a unique practice name. So it can be an internal code that you have like it could just be union in the profile. This is the name for the profile to, you know, just separate them and give them a unique name. So, so.
Jakelin Patino (21:45) Naomi, sorry to interrupt you. If we want to leave, it just has this like having 225 100 Morris, I’ve listened multiple times with instance, coastal aeg. And obviously, it’ll be us to monitor and maintain it because like for instance, let’s say coastal spine got up and left, then all those associated with coastal spine would be leaving with them. So then we would just associate those providers with that group. At one point. It wouldn’t that be an easier thing than having just 2,500 listed one time. And then figuring out from there. OK, well, who’s from what group or who left when, and where?
Naomi Denson (22:36) I need to take this back internally to our PE team to see what they recommend on the best setup to make sure that everything flows correctly. Have you shared this with us yet? No?
Jakelin Patino (22:51) I’ve been working on it. I haven’t shared it with you guys yet?
Naomi Denson (22:53) Can you share this with me as is right now so that I can show them exactly what we’re looking at before we make any changes and get a definitive decision on how best to organize this.
Jakelin Patino (23:07) Sure. I can definitely do that after the call. Yeah. OK. So then that answers that tab. So then wait, that brings up the question, then the provider practice group, please don’t mind this part. But right now listed is everyone’s primary location. It’s not listed by the additional locations they go to. So how would you want me to add that? In this sense? I think this is the one it’s one.
Naomi Denson (23:38) Row per group profile, per practice service location profile to associate the providers to all the practices that they could work at. Now with the provider enrollments tabs, say, dr… Bryson is enrolled with Aetna with five different practice locations under the same group.
Jakelin Patino (24:03) Then that’s.
Naomi Denson (24:05) going to be five separate rows for each practice location to show that the source of truth, what that medallion aims to be for you is that you can go in and look and say, hey, he’s already linked to these practice locations. He’s good to go. So.
Jakelin Patino (24:19) Then that same process will work here for instance.
Naomi Denson (24:21) It will work there. However, one thing to keep in mind is the provider enrollments tab, when we import existing enrollments, when they’re separated like that, one line per pair per practice. If we import an existing enrollment for a provider linked to five practice locations, it’s automatically going to do that association for the provider practice groups tab. So if we are importing existing provider enrollments and you’re going to list out every practice location they’re associated to with the payers, and that would cover all of their associations for the provider’s practices and groups. Okay? Yeah.
Jakelin Patino (24:58) The.
Naomi Denson (25:00) provider enrollments, when we import those will create the provider practice groups. So it’s just, it’s up to you. If you want to do the provider practice groups ahead of time or just focus on the provider enrollments and import that way. And then as you make new requests going forward, if you need to tie them to one group, you can make the request in the platform, request the new location and then that creates that association automatically.
Jakelin Patino (25:24) Okay. Only reason why I probably will keep this tab and finish it is because we do have certain providers who are not at all enrolled with payers at the moment and who may not down the line become enrolled. So they would just be associated to a location because they work strictly for instance, at a motor vehicle insurance and not health insurance. Okay? And it’s a little confusing but… yeah, I would.
Naomi Denson (25:58) Just prefer if you sent the sheet back to me, let me look at it on my own time really quickly, and then discuss it internally with the team so that we can confirm the best approach.
Jakelin Patino (26:12) Okay. And then this time for me, it’s completely blank. I’m still waiting for an answer from our broker. However some of our providers do have two insurances that are active at the same time. So I don’t know what would be the best course of action to list that. Do you want that individual rows or do you want me to add columns? Let me throw something in there for a little clarity. We have our own group policy, group occurrence policy that a lot of the providers are on. When these others join us. There are a couple of reasons why they may not join ours fully, but we just pick up vicarious liability on them so that the entity is fully protected, but they maintain their other policy to protect them individually. So that’s what Jackie means by the two policies. But since we’re talking about it, you know, if we’re talking about it at the entity level for vicarious liability, I would get the cois, anything else we have to, you know, get from them, if a payer is looking for what is covering them individually, as opposed to at the practice level, so which are you in need of?
Naomi Denson (27:37) So the malpractice insurance, I wouldn’t worry about that tab that’s going to come over with caqh.
Jakelin Patino (27:43) Okay. It’s in there as.
Naomi Denson (27:45) long as it’s in caqh, it’ll import when we load those.
Jakelin Patino (27:48) Not just singular. So you don’t need this one filled out in advance?
Naomi Denson (27:52) Yeah, I wouldn’t unless it’s confirmed that it’s not in caqh, but it would just create duplicate records if you load the sheet and caqh. So, I would hide this one and not worry about it.
Jakelin Patino (28:05) Right now. So we’ll skip this one for now. Yeah. And then the other one is external, which again just waiting on a few things to finish this tab over. But otherwise this is also set up, ignore columns me and C, that was me to make sure I didn’t miss anyone… but otherwise, I have no questions from that. Anything else you guys need to share for us?
Naomi Denson (28:28) No, I do have a hard stop to get to another call. But if you could just share this sheet with me, we can do a deeper dive in our weekly sync.
Jakelin Patino (28:37) Okay. Yeah. And the big thing, the biggest thing here is two things. One is, you know, understanding the best way to put it in, which is what the main thing is going to go back on is to understand the best way to put it in knowing that, you know, the group names are really just more internal tracking and not that we submit anything that way because everybody ends up being credentialed as far as premier brain is fine. And so just a matter of how you would like Jackie to complete those other pages. And then the other thing is just the reminder that come Tuesday, she’s gone for a week. Okay. And if she comes back, I go.
Naomi Denson (29:22) Okay. All right. Well, yes, I will look out for that sheet from you and then take a look at it and hopefully have some more clarifying. Okay, thanks.
Jakelin Patino (29:34) Naomi. Thank you everyone.
Naomi Denson (29:36) Bye.
Jakelin Patino (29:37) Bye bye.