Transcript
Amy Barfield (00:00) hey, how are you? How are you? I’m good. Yeah… had tornadoes here in Oklahoma.
Janette (00:12) Oh, my goodness. Are you serious?
Amy Barfield (00:16) Yes, last night, we were, I was just about to go to bed and our sirens started going off and I was like, I didn’t even know storms were coming, you know?
Janette (00:24) Oh my God. How can it be like that?
Amy Barfield (00:27) I know. And I just thought about you and us discussing that on our, when.
Janette (00:34) We met, that is insane. I honestly, I would be crazy.
Amy Barfield (00:39) Yep. So we got up and watched the news and waited until the warnings went by and it passed us and went to bed.
Janette (00:48) No, but it happens to be a month twice.
Amy Barfield (00:52) Yeah, they can, and the storms did pick up again… later that night, my dogs were going crazy and they, I’m one of those, I let them sleep with me. So they just kept pacing all over the bed and I’m like you’re inside you’re okay. You know? So we didn’t get much sleep around these parts.
Janette (01:18) It looks.
Amy Barfield (01:22) like you’re logged in twice. I,
Janette (01:24) don’t know why it keeps happening.
Amy Barfield (01:26) Let me try to bump you out on this one and see if that helps. Can you still hear me?
Janette (01:35) Yes. Okay. Good.
Amy Barfield (01:38) Good. Is Kristen going to be able to join today? I don’t know it happened on my last call with one of my clients.
Amy Barfield (01:44) So I wonder if it’s something with and this is a zoom? I thought we switched to teams. Do you want to switch it back to teams? I.
Janette (01:54) Would love that to teams. It’s so much easier.
Amy Barfield (01:58) All right. I’ll do that for starting next week. Let’s see… that way. You’ll probably get better notifications and stuff too.
Janette (02:11) I don’t think she’s going to join the meeting. I don’t know if she had something going on.
Amy Barfield (02:16) Okay. Let me switch this to teams. I don’t forget one thing to say… okay, future calls are teams? Okay. Good. Let me do the behavioral health one too, just to be on the safe side.
Janette (02:38) I think the zoom… one is just confusing me.
Amy Barfield (02:45) Yeah. Some people are fine with it and then, you know, I think the majority of our clients use teams, but we’re we can’t be easy. We have to use zoom, but I have an account now. I think with teams just for zoom calls for clients. So it should work fine for me now. Okay? So I moved those starting next week, so we shouldn’t have that issue. Let me go ahead and move the one for tomorrow as well. Teams.
Janette (03:18) I have a question, sure question and a comment. I know that you said that we’re not going to do the etins, you guys are not doing the etins anymore. And that’s something that we had to take over. And my question is for the folks that I’m going to request, how do we document that in medallion and then get the?
Janette (03:46) The mailing stuff over to them? How is that going to work? How did it work before that? You said Danielle slipped it in there? She put it like.
Amy Barfield (03:57) Slipped it in with a demographic update. So, she requested several things at one time and that’s how it got slipped in there.
Janette (04:04) Yeah, no, I mean, I understand, she said, but my question is how was it being done before for the etins like it?
Amy Barfield (04:12) Wasn’t yeah, we don’t do it for any client like at all because it’s not a, it’s not an enrollment issue as far as like provider enrollment and that. And so it’s more of a billing issue for… billing kind of like efts or eras or Edi set up, you know? And so it’s not something that medallion handles at all, but it just so happened, our team picked it up and started trying to work it. And so, and I really didn’t understand it from the beginning because I just didn’t have that level of experience in New York medicaid. So I assumed it was enrollment related until our director was like, no, this is a billing related issue. This is not something our teams handle. So when I found that out, you know, we continued to do work on it until she said, no, we just need to complete these enrollments because our part is done. So that’s where that came from. So there’s no way to track it in medallion, which was another thing it’s like how do you track etin revalidations and stuff like that? There isn’t a way because we don’t manage that.
Janette (05:32) Right. We were doing it by demographic update. So I guess my question now we’re just back to where, how we’re going to structure it because I’m just trying to figure out how it was done when Danielle was here. So you’re saying it was not part of the contract at all and, you know, I don’t know how long Danielle was here for two years or something like that.
Amy Barfield (05:54) Yeah. I don’t know how she managed it prior because we hadn’t done it before. And as you remember, she let it lapse. So it makes me wonder if she even was aware of it from the beginning. So, I wonder, you know, however it was managed prior to Danielle, it probably didn’t fall into her scope until like, you know, it was probably just completed right before Danielle started. And then it fell into her scope later on, you know? So yeah, I don’t know how that was previously managed… but I know medallion didn’t do it.
Janette (06:35) I’m going to have to talk to Kristen then because it’s a big problem for us if it’s not part of credentialing.
Amy Barfield (06:42) Yeah, you’ll have to find some type of internal way to keep track of those revalidations or something.
Janette (06:51) Yeah.
Amy Barfield (06:54) Okay. Let me get started here. I don’t know why my agenda is spinning. I’ll share my screen.
Amy Barfield (07:15) So, a couple things that were pending and I checked this on the thirteenth. Do you know if those par analysis got submitted for? Let me work… last. I checked, I didn’t see them in here.
Janette (07:38) I’m asking them now because they told me they did it.
Janette (07:42) Okay.
Amy Barfield (07:43) I just, I wonder if they did it like in a, how… they requested those? Because there’s a request type now for par analysis… group. Wait, I forgot that one. I want it. I… specifically.
Janette (08:05) Also.
Amy Barfield (08:10) Yeah, I only have Connecticut in here still.
Janette (08:23) Maybe I did it through email because I’m looking through the chat now.
Janette (09:09) Now, all the rosters and everything that I sent you for the anthem or par analysis that they sent me. You still needed it done on your side inside of medallion, right?
Amy Barfield (09:21) Yeah. I think the question is… they want to make sure that there’s.
Janette (09:28) I already verified on our ends because I sent you all of the I’m looking at the ones that I sent you and I thought I did every single one of them that I sent you through the anthem including verifying if we were participating with medicaid and the provider rep said, yes that we were, you.
Amy Barfield (09:45) Just didn’t confirm what type of contract it was like. So we’re trying to move forward with providers who aren’t on the roster and we need to confirm like are these group enrollment? Like is it a group enrollment or is it facility? Because facility we’re being told that they’re facility and that they don’t require enrollment. But then there’s… rosters that would indicate that there’s probably a group enrollment. So there’s just some confusion that we need to clarify so that we’re submitting these anthem enrollments because they’re not taking them. So we have to have something to say, no, we have a group enrollment here’s. Our confirmation, you know, from the rep.
Janette (10:32) Yeah, but they didn’t go through rep, it went through availability. I remember doing this, which is why I’m just like, no. So the one that you’re requesting is inside of medallion, right?
Amy Barfield (10:45) The par… analysis. Yeah… no, we, so whoever made the par analysis for medallion, Connecticut tried to add all states on that request and we have to have the states. So we have to have one for each state. Yeah. And so I’m not sure who’s in Belize. I think I can’t read that. It’s so small. I can’t.
Janette (11:19) see it either?
Amy Barfield (11:20) Yeah. Let me see if I can blur that up. So this is who requested it and they just requested all the states. So these have to be separated out.
Janette (11:32) Oh, that’s mark.
Amy Barfield (11:34) Okay. So we did get the status on Connecticut because… that’s what this request was for was Connecticut, but the other ones would have to be like, we don’t need New York. So we confirm that one. So we would need California, Virginia, Texas, and New Jersey.
Janette (11:58) Hold on. I’m going to my notes now.
Janette (12:07) No, it’s not.
Janette (12:17) Thank you, Janine.
Janette (12:54) Sorry, I’m going through my notes here, trying to figure out, I have like so many notes with you guys. And now I’m lost with all the ones I have you’re good nope, no issues.
Janette (13:11) All right. Let me set both those to the correct maintain shot.
Janette (14:02) Okay. Give me the states again.
Amy Barfield (14:05) California, New Jersey, Texas and Virginia.
Janette (14:43) Okay.
Janette (14:48) I just sent it to them again. I’ll find the thread but I know that on our ends, I can tell you for the anthem of New York, they were pretty adamant that each provider required credentialing. I know that you and I went back and forth on conversations with that, but I just have to find the thread. I’ve had a migraine for the last two days and I’m just trying to get through the day today. I.
Amy Barfield (15:15) Understand that was me the last two days too. I feel like I finally got over the hump.
Janette (15:21) Yeah, no, I ended up having to get iv meds because my blood pressure just skyrocketed last night and it was just crazy. So.
Amy Barfield (15:32) Is that normal or do you feel like it’s stress related?
Janette (15:34) No, it’s not. I usually, I mean, I get migraines but never that my blood pressure’s that elevated like my blood pressure was like 157 over 93 and I’m just like what the hell’s going on with me right now?
Amy Barfield (15:47) Do you take like a regular, maybe I’m getting too personal?
Janette (15:51) No, I don’t take any medication. I have the medication in case it does happen to me, but probably expired, but they just gave me like 800 milligrams of maltrin and, you know, at the hospital and stuff.
Amy Barfield (16:08) But… I’ve been taking it’s called ubrevli. You don’t have to take it every day. You just take it. When you feel one coming on, it takes about an hour to kick in but like I can deal with an hour versus two days, you know? But it’s not a daily medication. So I like that, but I don’t have to take it daily, but it seems to help.
Janette (16:34) Yeah, I don’t like taking medicine, to be honest. So, I tried doing it like on my own and I felt it coming on and I’m just like, okay, let me just monitor my blood pressure.
Amy Barfield (16:46) Peppermint oil too, helps like if you just dab it on your shoulder, yeah. So I’ll dab it on each of my like on each shoulder and it’s not like overpowering anything, but just as you inhale, it kind of relieves some of, the pain part of it.
Janette (17:05) That’s interesting. Yeah.
Amy Barfield (17:08) Or sometimes if it’s really bad, I’ll just put a little in my hand and just cut my hands and smell it and it helps.
Janette (17:14) Peppermint oil. Yep. Yeah.
Amy Barfield (17:19) We use it for a lot of things around here. Yeah, I prefer natural or like vitamin supplements over like taking a medication, but sometimes you get desperate, you know?
Janette (17:33) I’m going to have to buy one.
Amy Barfield (17:36) Yes. Okay. So I think you had mentioned getting the email addresses updated in medallion you were going to delegate that out to possibly your onboarding team or someone who handles a group profiles. Were you able to relay that?
Janette (17:53) Yes, I did, and I have to follow up. So I went in there today actually to look at some of them and… they either have provider enrollment or it’s blank. So we’re just going to have, we’re just going to put credentialing for all of them across the board.
Amy Barfield (18:14) Okay. Even your behavioral health ones. Well.
Janette (18:18) The behavioral health will have to still do for the email mental health. And then for the other section, the credentialing, okay? And that’s a Sheena preference. So I’m trying to accommodate her for it.
Amy Barfield (18:30) For sure. Okay. We had discussed issue of terminated providers still receiving outreach.
Janette (18:40) Yes, we’re going to confirm if that was possible to fix.
Amy Barfield (18:45) Okay. I was like, I don’t remember exactly what we discussed there. So there is go ahead the.
Janette (18:53) Issue is that, you know, we keep getting notices the providers are getting. I actually have one provider that Christina… is Christina a person or, you know, I never know when I’m talking to somebody.
Amy Barfield (19:06) Yes, Christina is a person she’s our lead in support. Yeah, she’s like the go.
Janette (19:11) To, so, she had replied that it doesn’t generate it and I’m like, I mean, I beg to differ. I didn’t reply to her. I’m to it and there was three other providers that were on it. The only reason why it was created was because they received an email for it and the notification was the team’s manager.
Amy Barfield (19:32) Okay. I remember. So if they’re still active in medallion, then they still go through their normal processes. So I just need to confirm that if they have a term date that they’re not being credentialed right?
Janette (19:46) Right, right. That’s what I want. Okay? So there’s no outreach happening.
Amy Barfield (20:08) Okay. Thank you for clarifying that. I was like, I remember talking about it, but I don’t remember exactly what I was supposed to do there. Yeah. So I know like ncqa standards are that if they are approved or recredentialing is approved, that they have to get a response regardless of what their email preferences are. So that makes sense like if they’re not… if they just need to do some kind of setting to where we’re not doing recredentialing if there’s a term date in place. So I’ll yeah, I’ll reach out and find out what we can do there.
Janette (20:49) Okay. I.
Amy Barfield (20:51) wanted to review your onboarding analytics because that changed since we looked over that. Let me get into your view here. Actually. Yeah, let me get it here. Where’s it at?
Amy Barfield (21:14) It used to be right here. There, it is. So before it was on an average and you saw that number was pretty high. And so they changed it to where it’s based on a median and you can do it by months… out, you know? So let’s see. We’re going to go to provider onboarding… and it was 21 the other day. So let’s see if it changed at all from like what was it? 37. So total turnaround time. Let me do a filter here. This is last 12 months is eight. So that’s way better and that’s the median. So not the average.
Janette (22:09) Yeah.
Amy Barfield (22:13) Yeah.
Janette (22:13) Hold on. Let me, Kristen had a question about that. Let me see.
Janette (22:27) No.
Janette (22:54) And she had a question in regards to the average time… but it’s updated. So I’m glad.
Amy Barfield (23:05) Yeah. So this is your total and then from invite to join. So it takes the medians two days for your providers, to log in and join. And then from joined to profile completion is a median of four.
Janette (23:25) So, well, I like the way that it’s broken down that way because it’s easier, to read, right? I.
Amy Barfield (23:32) Think if you can deselect certain things from here… and it’ll change this graph, you can download this reporting here and it tells you each provider and how long they were in that process. So like if you see one that’s kind of, these… are all 100 percent done. And you’ve got a few here that are not complete. So you can do like filter and find out which profiles are not complete. So this will be good for your onboarding team to like keep tabs on providers to make sure they’re completing their profile. So you’ve got some right here that aren’t 100 percent complete or they can review them and see like, is this a true holdup or can we push this through to… a… push this through intake? And then they can just send something to support and say, hey, we don’t have that, please push through to intake. So, so like this provider’s only at 31 percent and, they were invited on five nine, joined on 512. That was 20. That was a while ago. So is she even here still 31 percent, you know? So those are the things that I would look at. If I was doing onboarding. Does she have any current requests that are pending? That type of thing here’s. One, we need to update her name. She’s termed, but her profile is only at 66. So if we go to her… I wonder if she’s got any requests that are pending that’s causing this to?
Janette (25:19) Hold up. And the turnaround time that you’re showing me for the eight that’s how long it takes them on average to complete their part, right? Yes, it’s.
Amy Barfield (25:28) a, it’s a median versus an average… because the average creates a bigger instead… of it creates an average of all the numbers versus like looking at all of them and seeing like where’s the middle number between all of them? Do you know what I mean?
Janette (25:48) Yeah, yeah, no, I understand. I like this way better. I think it’s a lot cleaner. And so I think the last part we need to do is the submission one, right? So now this is the, they complete it and then how long it takes us to compile gather all the information to the submission because that was the other question we had whether we were giving the right information for submission to complete?
Amy Barfield (26:18) Yes.
Amy Barfield (26:24) Let me see if there’s something you can look in here. So these are all your enrollments… that are in progress. Let me see if there’s a submission date on here. What’s completed?
Amy Barfield (26:41) Here’s your median turnaround times. So this will give you an overall of like how long they’ve been in intake, how long it took from request to complete request to first app submitted, intake… complete to first app submission. So here’s those numbers here. Those medians… is that kind of what you’re and then here’s from first app submission to request complete. So there’s a median of 46 days?
Janette (27:10) Yeah. I just, I think Kristen needs to rerun the report. So I’ll talk to her.
Amy Barfield (27:15) Okay. And we’ve got some payor turnaround times too. So that’s really nice. We didn’t have that before and by state. So you can see like which ones are taking longer for pmps versus and which payors are taking longer. So that might help you in staffing, you know, appropriate areas or where we need to look at a more streamlined process for getting quicker turnaround times. So it’s broke down by state and payer.
Amy Barfield (27:54) Any other questions on those?
Janette (27:57) No, no, I’ll go in and play with the report?
Amy Barfield (28:01) Okay. Cool. What else? Do we have a list of new providers to medallion to help track time to revenue? And I guess you’d be working with your, is it Diana? Okay.
Janette (28:18) Yeah. I already, I just, she already sent the request for the onboarding. I just asked her if the provider has already. I mean the person who’s sending the term dates to send the onboarding… ones, will the term ones help you as well?
Amy Barfield (28:37) I mean, it’s… always nice to know the term ones. So we know if we need to like… deactivate… a provider from medallion, but you have that ability, right? To.
Janette (28:52) Deactivate? Yeah.
Amy Barfield (28:53) Yeah. So you can do that on your side, but if we’re just looking at turnaround times for providers that are in the system then… or active, then I guess we wouldn’t need the term providers unless they’re still in medallion?
Janette (29:09) Yeah. No, I mean, there’s a lot that are still in medallion with termination dates.
Amy Barfield (29:13) For sure.
Janette (29:14) There’s tons of them. So maybe I’ll just do an exercise to go. The exercise was for Kristen’s team was to go through the termination report and then do a comparison with activity of claims and then ones that had zero balances with activities was to term all those providers. Yes. Yeah.
Janette (29:44) So I’ll bring it up again to her team that they’re the experts doing the vlookup and doing all that stuff. Okay?
Amy Barfield (29:56) You mentioned on Monday’s call that you wanted to ensure we’re using the most recent forms for medicaid applications. Was this for New York particularly?
Janette (30:06) For who was this?
Amy Barfield (30:08) For New York particularly?
Janette (30:11) Yes, we received a notice… an email that they used the wrong New York. No, yes. It was New York. The one that used the wrong form. And then you’ve seen the optum complaint, right?
Amy Barfield (30:29) Yes. And I did flag that too.
Janette (30:31) Yeah. So, are you guys using, I hate to ask this, but are you using people out of like a third party vendor to do all these follow ups as well? Because I don’t know if they’re being trained appropriately, this specific one that she used, the doo was filled out completely wrong. I asked.
Amy Barfield (30:57) about the doo, and our specialist said that the doo gets sent to the provider and the provider is filling it out.
Janette (31:08) Yeah. So why did she fill it out? Usually? I fill it out. Any doos that come through. I’m the one that’s taking care of it because they’re you know, they’re the owners that we need to make sure that everything is done correctly. But this particular person, I don’t know who she is. Her name is on the example of ones I sent you. And there were two different ones that did it. It wasn’t just her. Then it was somebody else that sent it back in and both of them did it wrong and put like one of the owners as one of the providers. So she asked, I guess she just got frustrated and she’s like you guys continue to send me the wrong information on here. And then one of them, I’m sorry. And then one of them put in the wrong mpi number that belonged to a different doctor completely. So, you know, it was just mistake after mistake is what they found. Okay?
Amy Barfield (32:02) Yeah. I did flag it to her. She did respond that the provider is filling it out, which I didn’t understand. So thank you for clarifying that. And then, yeah, the mpi, do you want those to just be an admin task? So that you’re filling all those out… the dros?
Janette (32:22) Yeah. I mean, I don’t have, I just talked about getting signatures for that because right now I’m putting my name on it. Yeah. And I should be putting the, you know, each owner, their name on it. So, I noticed… that they have David’s signature on one of the forms that they filled out, but I don’t have that.
Amy Barfield (32:44) Okay. Is it, I haven’t seen this dro form or looked at it in depth? Is it a stagnant form? Like we could just have on file? It’s.
Janette (32:55) not, well, it’s pretty standard. Yeah. The only one that’s changing more so is New Jersey because we have the new ownership structure that just started with st Barnabas for 51 percent. And then 49. I think it was for David Matheson for our Livingston address that’s the only change that we’ve had and, you know, she, I sent our legal department the information, but she hasn’t got back to me about it. So, I’m going to follow up with her as well. Okay. So we can update the ownership information. She never sent that to me. Okay?
Amy Barfield (33:36) That’s all I have on my agenda. I’m sure you have some things that you want to go over the.
Janette (33:43) Only thing I have is if there’s any way that I can get access to seeing who’s making mistakes inside of medallion for us because I just found another mistake that was made and somebody keeps adding practices like they’re combining urgent care practices with BH practices that have no business being in there. And it’s so frustrating because, you know, I have to open a ticket and then ticket will come back and say, no, you have access. This is what you need to do. And then I’m like, no, I don’t have access. You need to give it to me. And it’s happened multiple times. So, I don’t know if just to look at demographic update, if it’s possible, Amy?
Amy Barfield (34:25) I mean.
Janette (34:28) I just don’t want to keep opening tickets with it. I just found one today that they took one of our BH locations and added it to an urgent care location. And I know it’s the access team staff. I just need to be.
Amy Barfield (34:42) Able to, is it under group profiles or like a request?
Janette (34:46) Go into Selden… okay. Selden group.
Janette (35:00) Yeah. What is it? SELDEN?
Janette (35:13) And so we clean them up and then somebody goes back in there and adds them back in there. I’m just like, what are you guys doing to me? You’re killing me? See the first one? Yeah, that doesn’t belong there. Okay?
Amy Barfield (35:27) It’s already here. It doesn’t belong here.
Janette (35:30) I’m just like, why does somebody keep doing that to us?
Amy Barfield (35:34) Okay. Let me at least flag it, and then I’ll make a suggestion also to.
Janette (35:55) Maybe we can put something like when they’re about to add a new location. Are you sure you want to add to this location? You know, I know it may be redundant, but at least it helps.
Amy Barfield (36:07) Do you want me to delete that? Well? I want tech support to see it first so they can tell who did it, and then we can delete after.
Janette (36:16) Okay.
Amy Barfield (36:17) Okay. Anything else that’s it? All right. Okay. Well, have a great rest of your week and I’ll see you on Monday.
Janette (36:29) All right. Thank you. Have a good one. Thank, you too. Bye bye.