Transcript
Connor Morley (00:00) hey, good morning. Everyone. Good morning.
Alicia Iannece (00:05) I’m having trouble with my video today.
Connor Morley (00:08) No worries. Hey, Adele. Hi, everyone.
Connor Morley (00:18) Okay. Alicia. Just to give you an update, our engineering team is working on those dop forms and getting you access to sign off. They are looking into why it’s not appearing and that user that was able to sign it but only with an email was actually really helpful for them to start the diagnosis of the issue. So, I’m hoping to get an update from them later today and an emergency release to make sure that your providers can sign these documents.
Alicia Iannece (00:55) Okay.
Connor Morley (00:57) All right.
Alicia Iannece (00:58) And I did see, do you see the one support ticket? I don’t know that. I don’t think I copied you on it. One of our providers had or their credentialing contact had put in a support ticket for them having trouble, and they’ve got that, it looks like a pop up blocker or something… but he says he has checked all that and doesn’t know what the issue is.
Connor Morley (01:27) Yeah. I spoke with our tech support team and our engineering team yesterday to reiterate that it’s not an issue with like a pop up blocker or anything. Yeah, I was able to replicate the issue and then I walked them through the steps on how to replicate the issue as well so they can see it… and they’re working on the fix right now. So, let me talk to our tech support team to make sure that they should not be kind of telling the providers it’s a pop up blocker issue.
Alicia Iannece (02:02) Okay.
Connor Morley (02:05) All right. Before we get into the rest of today, I did just want to ask you all a quick question. So our product team is looking for some additional feedback on tjc… credentialing process and how we can improve the overall workflow in general, our engineering team is working on those dop form signatures, but we also want to know a couple different things on how we can kind of improve the committee workflow… things like quorum questions. We have a lot of questions. So, I was wondering if you would all be open to maybe a 45 minute call with our product team to deliver some feedback with them on how your current credentialing process works.
Alicia Iannece (03:02) Sure. Yeah, I will just say, I know every organization does it a little bit differently as far as what their committees do. So just keep that in mind.
Connor Morley (03:11) Yep, 100 percent. Okay. And I’ve given them that feedback as well. I think we’re just trying to see what some shared workflows are and if there are a lot of different pieces, how to best build it so that it fits everyone. Okay? And I know we’re going to ask a little bit about committee voting, clean versus non clean files, quorum board, ratification audit trails, and then any like post committee review. So I can definitely send you some of those questions ahead of time if that helps.
Alicia Iannece (03:50) Sure that’d be fine. And probably you’d probably only need to include like Jenny and dr baker and myself, everyone else is like more payer focused. So if that’s helpful.
Connor Morley (04:03) Great, perfect.
Alicia Iannece (04:05) And then if there’s an opportunity to add a topic, I would suggest the consideration of like temporary privileges too because that has, it doesn’t go through full committee but still has to have some sort of approval process which is usually abbreviated. I don’t know if it’s worth bringing into that conversation or not. But just suggesting it, I.
Connor Morley (04:26) think it would be worth bringing in. Especially I’ve submitted tickets about temporary privileging and given the product feedback, but I think it always helps product to hear from you guys because it’s not just your organization, temporary privileges happen everywhere.
Alicia Iannece (04:42) Yeah, absolutely. Okay.
Connor Morley (04:48) Adele, did you have any updates on those roster templates or any questions that you’d like to ask?
Adalee Arreola (04:54) No questions at the moment. I realize that I haven’t sent it out. So I’m going to send out the updated samples today so you all can see them just based off of the feedback that you all gave me last week… but yeah, I’ll add some like additional notes there. I’ll get those sent out today. I.
Alicia Iannece (05:21) Do have a couple questions on the provider enrollments tab. I’m almost done. I’m just finalizing a couple things. And as I was thinking through a few, I wanted to ask here to the group again… regarding. So we have four providers that we’ve been kind of holding on as far as adding a location to the payers because of waiting for this build and having it all set up correctly? So would… I, so they’re fully credentialed with payers at one location and we need to add a second location. Would I put those in as a line item with non par? Or would I leave them out altogether because once it’s built out, we’re going to put in a request for a demo demographic update?
Connor Morley (06:12) So really quick, can I just confirm that those practice locations are in the system right now or is that?
Alicia Iannece (06:20) Yes, they are okay?
Connor Morley (06:26) So, I would say it is kind of up to you how you want to handle this if we load them and you immediately make a request or do a demographic update. I don’t think the non par lines are needed but curious… Rheta, if you think differently… no.
Rheta Larson (06:51) I think I’m aligned there because I also was trying to, I know you were questioning those two providers… mark and I forget the other provider’s name, but I know it’s a similar vote for that, and I think the team also agreed that the non par wouldn’t need to be input then or like we wouldn’t need to, you wouldn’t have a request for those, right?
Alicia Iannece (07:20) I’m sorry, are you talking about the medicaid ones that we’re I feel like it’s different, two different things.
Rheta Larson (07:29) Yeah. I was sorry. I thought it was one and the same. So, can… you repeat the question? I’m sorry, I was thinking those part questions, yeah.
Alicia Iannece (07:39) I have four providers for two different reasons, but just, we were waiting to do a demographic update and add a location for them until the medallion, this portion of the medallion platform was built out. Because they’re already fully credentialed, they just need a location added. So, I, as far as having them in the provider enrollments spreadsheet with the par versus non par. I currently have them in the spreadsheet as non par, but I’m wondering if I take them out altogether because once this spreadsheet gets uploaded, we’re going to request those location adds.
Rheta Larson (08:19) Yeah, I don’t I think what Connor suggested is fine. Like I’m aligned there. I don’t think we should, I don’t think it will hinder anything if you just omit them or keep them off.
Alicia Iannece (08:28) Okay. Because I was thinking if I have them as non par, and then I request the location add. Is that going to make like confusion in the system if… it says non par and then adding it? Yeah.
Rheta Larson (08:42) From the team’s perspective with the requests, it will, that’s kind of what I was alluding to on the other ones and I think they were a bit confused as well with the ask there. Okay? So I think we’ll stick to that workflow just so it’s streamlined and we’re not seeing additional info that’s not necessary like for the team’s action anyway.
Alicia Iannece (09:02) Okay. Sounds good. So then there’s really going to be one provider who’s non par with one payer, and then these other ones I’m taking out as line items altogether… and then everything else is par. And then we took out the pharmacists who are non par, but potentially could be in the future once those payers approve them. Okay. Well, I will do that. I think that was my last little question. Oh, and then, so for tricare being… that we’re going to enroll them as non network providers on those line items, I’m going to have them as direct enrollment, but I did have a note in our notes that for hospital based providers, we don’t have to do credentialing. So for those ones, I was going to put no credentialing required. Does that sound accurate?
Rheta Larson (10:04) Yep. Yeah, that is accurate. You can put the note in there and the team will look at that.
Alicia Iannece (10:09) Okay. And this is all for tricare, you said, yeah, for tricare and Peter on our extra call yesterday, Rheta was explaining that for tricare, we do still need to enroll providers and enroll them as non network providers. Okay?
Peter Frutiger (10:27) Typical tricare, let’s create a lot of red tape that we’re not going to pay you for.
Alicia Iannece (10:31) Right. And then for the issue, Peter, you were copied on the issue with dr. Gertenson. I am, I’ve reached out to tricare to just ask if we’re doing a new enrollment versus a revalidation, and then we’ll take care of it. Okay? Sounds good or we’ll submit it to medallion to take care of it.
Peter Frutiger (10:51) Yeah, we’ll see what the response is. I just don’t trust them right now.
Alicia Iannece (10:56) Thank you. Okay. Thank you guys. Yep.
Connor Morley (11:04) No problem. All right. I know we spoke yesterday on a handful of different follow ups that we’re still tracking the big pieces that were remaining for the implementation are going to be that delegated rosters, getting you the sample and getting those out the door to you for the end of the month and then getting these provider enrollments loaded, I would say is, and then also making sure that your tgc credentialing workflow can go through all the way and getting these dop forms signed.
Connor Morley (11:46) That kind of covers our current outstanding blockers. I was looking, your groups look good. Your practices look good. The payer enrollment requests are in process and we’ve got a number of them already completed. It looks like about 1,748 are currently processing with the majority of those 48 currently waiting to hear back from the payers.
Connor Morley (12:24) All right. And,
Alicia Iannece (12:27) sorry to clarify for the ones for tricare, Rheta. You said they’re going to just go ahead and like do that updated submission of the non network enrollment, right? We don’t need to add any notes or anything?
Rheta Larson (12:40) Yeah. The ones that we flagged for Tenzin, Sean smith, the team is just going to proceed with those or? Sorry, Tenzin?
Alicia Iannece (12:50) Sean smith, I think that’s right? Yeah, yeah.
Rheta Larson (12:53) Yeah. Okay. I just wanted to revisit the note that I said yesterday and make sure I’m not confusing them with another pair. Sure, the list that we audited, those are the ones that were also, you don’t need to input another request. I think that’s what I was thinking of for those cross comparison lists or the ones that were submitted as initial, but they should have been revalidations. The team actually went through a lot of those. The ones that I called out yesterday, I think there was a few providers. Most of them, they did double check. It looked like the notes were actually incorrect and some of them were submitted as revalidations. They went back and changed the notes. So you should see that reflect on the ones that were submitted correctly. And then they just resubmitted the other ones that were not submitted correctly?
Alicia Iannece (13:41) Okay. Sounds good.
Connor Morley (13:44) Rheta for tricare, have the project plans been updated for the hospital as first non network?
Rheta Larson (13:52) Not at this time. I can work on that as well. And Connor, I can partner with you there just for anything.
Connor Morley (14:04) Okay. Sounds good. Yeah. Just want to make sure we’ve put this in the payr project plan for tricare?
Rheta Larson (14:17) I actually did have an update for one of the outstanding items that we discussed yesterday, for Ariel bodeker, that credit charge that came through. We did get the confirmation back from Nick and the accounting team. So because it was consumed, we had asked for a credit there. So we did get the approval for the consumption credit and it’s been submitted. So you should be seeing that or hearing from our accounting team or am, which is Nick?
Alicia Iannece (14:46) Okay. Sounds good. I’ll have to reach out to Nick too. I don’t know if maybe at this point, it’s appropriate to start having some of those calls… because I don’t know where to go and see the consumption. I went into the analytics tab a little bit, but I think I’ll definitely need him to walk us through it.
Connor Morley (15:08) Yeah, it’s actually not in the analytics tab. It’s a little confusing. Okay? But it is within the account tab. Oh, okay. And there’s general and usage, but he’ll walk you through kind of how to look at that and kind of keep track of that.
Alicia Iannece (15:28) Sounds good. Okay?
Connor Morley (15:31) I’ll ping him to let him know that you guys are ready to go through those usage numbers as well. Okay?
Alicia Iannece (15:38) I’m seeing it now. Thank you.
Rheta Larson (15:40) Yep. No problem.
Alicia Iannece (15:44) Okay. So regarding the caqh management product then. So if I’m seeing it on requests, then does that mean it’s being consumed as a usage charge? Because I’m seeing here consumption by product?
Connor Morley (16:02) It should not, if that, if it is showing up, we can remove that on our side because caqh management is not checked and we’ve removed them from the provider profile so we can go in and remove those usages. So.
Alicia Iannece (16:18) Do I have the ability to drill down from the consumption by product or is it just in the consumption details there?
Connor Morley (16:27) Yeah, it looks like it would be in the consumption details where you would be able to go and specify or filter by the product name.
Alicia Iannece (16:38) Okay, perfect. Okay.
Connor Morley (16:47) And then there’s also consumption date ranges that you could adjust as well. Okay? But I’ll let Nick kind of drill down with you on that.
Alicia Iannece (16:59) Sounds good. Thank you.
Rheta Larson (17:11) I’m just going through our list from yesterday. I think the only other call out I had was, I know with Peter being here, the aspirus call out for the follow up to the payer. I just want to reiterate what I discussed yesterday with the team that we have made note that this payer does require the submission to pause to reach out until that 40 fifth day. So, what we’ve done is we’ve updated our internal resources and coached the team to reach out to the payer on the thirtieth day, post application submission. I can’t guarantee that there won’t be some that slip through the cracks where we contact the payer. So definitely, if you see any emails that come through from the payer, let us know, but we forwarded that email correspondence over to the managers on the PE team as well. So they’ll definitely be syncing with the team there. And then we’ll also include the copy of the submitted application on the email inquiries. When we reach out. So you should see that PDF document attached in the notes. Our normal cadence will remain the same. So you’ll still see our follow up notes. It just won’t we won’t reach out to the payer till the thirtieth day.
Peter Frutiger (18:20) I’ll just give staff a heads up. They don’t overreact when they get emails from the payer.
Alicia Iannece (18:27) Yeah, feel.
Rheta Larson (18:29) Free to pass along that we are working on it internally. I know the other part of that was the individual email access. I think I’m still pending a review from the team on that one. So I’ll get back to you on the portal access there versus using the medallion ones. But there’s a lot of payers that fall into that bucket where they want us to wait until the thirtieth day. So I don’t have a list unfortunately that I can provide. But if you see any more definitely flag them and I can relay that to the teams.
Alicia Iannece (18:55) You got it. Thank you. All right.
Connor Morley (19:03) Any other questions you all had for us?
Alicia Iannece (19:07) I have a couple follow up things. Just one thing I noticed yesterday with Jenny, Adam, I’m supporting her role a little bit with the, you know, hospital affiliation verifications. I noticed for one of the providers, we received an email three separate times asking for the same document and we responded all three times with that document. So, and it’s been over a course of two weeks. So, I’m not sure what happened there. I don’t know if you want more detail on which provider or what for follow up, but it was all sent to the medallion privileging email.
Connor Morley (19:47) What was the provider name?
Alicia Iannece (19:50) Kenneth Olson?
Alicia Iannece (19:52) And it was a hospital affiliation verification. The first request was on March 30 first and then on April first and we sent it back on April first and then they emailed again on April seventh and we sent it back on April seventh.
Connor Morley (20:09) Okay. Let me follow up with the team on that and.
Alicia Iannece (20:14) Then April fourteenth as well yesterday, and I sent another, I sent one of those same ones back.
Rheta Larson (20:20) Because.
Alicia Iannece (20:20) I think Jenny didn’t realize she had already done it. So she created a new one on April seventh. Yeah.
Connor Morley (20:25) Let me follow up with the team to see what is going on with that.
Connor Morley (20:36) Was that the only question?
Alicia Iannece (20:39) No, sorry. I will pull up my notes. I also noticed unlike trueshell Shaw, I… was just doing a check of the charges that came through and saw that the employment… history, like through the work number, I was reviewing those charges and it does look correct that we only had one charge, but I, for trueshell Shaw, I am in his documents, seeing eight copies of the same, the work number document. So I don’t know why that’s happening and it was done by four. It looks like it was done by four different people in medallion. So I don’t know. I’m just calling it out and… I bet it’s probably still there. If you go and search in his profile. I just had a screenshot.
Connor Morley (21:30) Sorry, in which piece of his profile, the work?
Alicia Iannece (21:34) In the documents tab, And it was his work number verification.
Rheta Larson (21:40) Okay. Work number in?
Alicia Iannece (21:43) Second.
Connor Morley (21:45) Yeah, it looks like, yeah… four different work numbers.
Alicia Iannece (21:52) There’s actually eight eight. Oh my God, I.
Rheta Larson (21:56) see the eight, but I think there might be duplicates. I don’t know if the system was, it’s because it’s all on the same day. So it looks like the same users uploaded to each and they’re both the same like they’re both duplicates just based off of what I’m seeing. So I think that just might be the system duplicating it when they say or like something happened there with the bug.
Connor Morley (22:21) Yeah. Rheta, do you mind checking on that one?
Rheta Larson (22:24) Yeah, yeah, I can look into this one further. I think it’s really four but still, I think the four is still.
Alicia Iannece (22:29) Excessive. Yeah, I agree.
Rheta Larson (22:34) Yeah. Let me take that one back too, and I can dig into it further.
Alicia Iannece (22:40) Interesting. And then let’s see. I did start digging into some of the work verifications, and I don’t know without Jennifer and Michael on the call, if I should go through them with you guys. But yeah, one big call out is for like hospital affiliations that are already created. I wanted to like just go in and edit their admitting privileges because, right? They’re all putting them in as admitting or most of them, I did see some providers have correctly put in non admitting, but not necessarily for all of their locations when I know they should be for all their locations. So, I wanted to just go in and edit that, but that box is actually grayed out altogether. So I don’t know if I have to create a new hospital affiliation to correct that.
Alicia Iannece (23:37) But so like admitting type is grayed out. Once that affiliation is created, do you?
Rheta Larson (23:45) Have an example of one that looks like that because the one I’m looking at, I see I can edit each.
Alicia Iannece (23:50) One. Yeah, sure. Douglas bull is an example Douglas.
Rheta Larson (24:04) I’m going down… for richland hospital on the hospital affiliation?
Alicia Iannece (24:17) Yeah, for sure for reedsburg, because that’s us. But for richland, I’m assuming not for richland, but I wouldn’t know for sure. But I go in and click the edit button and admitting privilege type is.
Rheta Larson (24:29) Grayed out. Oh, I see what you’re saying. I think, I mean, yeah, I would say in this instance, since you can’t edit, it would be the delete function and then re adding the hospital affiliation. Okay? I don’t know why we can’t edit that.
Connor Morley (24:49) Yeah, but we’ll follow up to see if we can get that editable. Okay?
Rheta Larson (24:57) I’m hijacked as an admin right now. Let me see on our side if we can do the same or if it’s also blocked.
Connor Morley (25:05) Yeah, Rheta, as a staff user, I’m not able to edit it.
Rheta Larson (25:08) No. Okay. There must be a reason for that, but yeah, we can dig into it further and see if the ability to edit those should be there or if they’re just the workflow is to delete and then re, add. Okay, but you’re working on that audit for those in flight staff applications. Is that what this is stemming from? Yeah.
Alicia Iannece (25:27) I’ve got a handful done and I’ve you know, I’m seeing the issues that need to be corrected, but I wasn’t sure if I need to go in and do I just go ahead and go in and start adding or deleting if I need to? Yeah?
Rheta Larson (25:42) Let me get back to you. And then I know Jennifer’s on copy on that email so I can start that thread again in the email correspondence and then just highlight the fact that one you can’t edit. And then the next steps for you, would it be to delete and then re, add before we make any changes, that would be my best approach since we can’t do it right now or keep that there and then just add a whole new record and then we can go back and clean it up. But yeah, I can loop in Jennifer here. Okay?
Alicia Iannece (26:08) Yeah. And then… I know, you know, catching up on the work verifications for now, we did receive one on a provider that’s not employed by us. So I was like, okay, I’ll have to go back and check that one and make sure. So again, I’m just wanting to be sure. I’m just worried it’s going to mess things up in the privileging application process… because verifications are going out already. And… I mean, I guess if they’re wrong, they’ll hopefully get returned, but.
Rheta Larson (26:45) Yeah, I will, I know Jennifer said she was going to work on it this week. So I’ll make sure that she reaches out to you before at least this today, if not before end of week just to give you a status update on that. Okay? Sounds good. But if you have like if you’re compiling a list or a spreadsheet or anything, feel free to pass that along as well. I don’t know how y’all, plan to divide and conquer it. But… yeah, we can cross compare anything that you’ve found and then you can pass it off and we can finish the rest or vice versa. I can ask if she has something started. Okay?
Alicia Iannece (27:19) It’s on paper so far so I’ll have to figure out how to make that look.
Rheta Larson (27:24) No worries.
Alicia Iannece (27:28) Let me just go back to my other questions.
Alicia Iannece (27:37) Oh, I did not give Adalee feedback yet on the board certification stuff for the roster updates. So you might have been waiting for me on that. I just saw my old notes. I’m sorry?
Adalee Arreola (27:47) Yeah, that’s okay.
Alicia Iannece (27:49) And you still need it?
Adalee Arreola (27:50) Yes, if you can give an update, I can make the quick update if not, if there’s like a second round of feedback, I can make it then.
Alicia Iannece (27:58) Okay. Sounds good. Yeah. If you’re close to sending an updated version, then maybe I’ll wait till the next one.
Adalee Arreola (28:04) Yes, I did generate them. Okay? Sounds.
Alicia Iannece (28:07) Good. Thank you. Sorry about that. No problem.
Alicia Iannece (28:17) We did submit a question to joint commission for board certifications and what are the expectations for monitoring. So hopefully we’ll get that back within the next day or two. And then I am waiting on signing on, you know, getting the, okay for the delegated agreement just for that one topic, but that I think, is it for now? I don’t think I have any other major questions right now. I didn’t have Jenny this week, to point out other issues she was finding, no.
Connor Morley (28:52) You’re.
Rheta Larson (28:56) fine. We definitely have a few pieces from yesterday too that are new that we haven’t necessarily worked through yet. So, some of the newer questions and the ones that have not yet been answered by our team, I’ll definitely make sure we get resolutions to you via email if they come before our next sync on Tuesday.
Alicia Iannece (29:14) Okay. And the dop stuff is, I think probably high priority, right? Like, I think it’s hard because I’m seeing new providers are getting dop forms still, but it’s still, we still know it’s broken. So, I’m not reaching out to them to sign them at all. If they’re choosing to log in and sign then and still having those issues, then that’s happening, but I haven’t we haven’t been proactively reaching out to them yet. Yep.
Connor Morley (29:41) That is the highest priority right now that has been escalated within our engineering department.
Alicia Iannece (29:51) Okay. Sounds good. Okay. All right. Then, I think we can probably wrap up early today.
Connor Morley (29:59) All right. Sounds good. I pinged Nick about going through the usage tab with you. He should be reaching out to set up some time to.
Rheta Larson (30:07) Cover that, okay?
Connor Morley (30:09) Sounds good.
Rheta Larson (30:10) All right. Well.
Connor Morley (30:12) Thanks, everybody. Thank.
Alicia Iannece (30:14) You guys have a good day, everyone.