Transcript
Kelly Martinelli (00:00) good morning. Good morning. How are you? I?
Lyndsey Farmer (00:03) Am good. How are you?
Kelly Martinelli (00:04) I’m okay, good.
Kat Rivera (00:06) Good morning.
Lyndsey Farmer (00:07) Good morning. I apologize. I am trying to turn my camera on and I keep getting a zoom message saying, failed to start video camera. So, it,
Kelly Martinelli (00:17) is a Wednesday? It’s okay?
Lyndsey Farmer (00:18) Right. Not sure what’s going on. So, no, if you guys want to turn yours off, I’m totally fine with that. I don’t.
Kat Rivera (00:25) know.
Lyndsey Farmer (00:26) Yep, totally. Totally good. I don’t know what’s going on, but it’s more like a Monday than a Wednesday. So… all right. Are we pending? Oh, somebody else just joined.
Kelly Martinelli (00:37) Michael, Michael’s joining. Let’s see.
Michael (00:41) Yep. I’m here, Kelly.
Kelly Martinelli (00:51) Thank you for. Thanks for joining, Michael. Yeah.
Michael (00:53) Sorry, I didn’t realize it was zoom and my new laptop doesn’t have zoom on it.
Kelly Martinelli (00:59) Hey, I’ll be the only one on camera. I don’t care.
Lyndsey Farmer (01:01) I don’t.
Kelly Martinelli (01:02) care. If you’re all schleppers, it’s all right. I’m just going to make fun of you. It’s all right.
Michael (01:06) I can prop my phone up. I think it works on my phone.
Kelly Martinelli (01:10) Lindsay, I do have one. I have a question before we get started about medallion.
Kat Rivera (01:14) Sure. Okay. So.
Kelly Martinelli (01:15) I’m going to share my screen real quick. Okay. You can see this, right?
Lyndsey Farmer (01:22) It’s coming one second. Okay. Yeah. Now, I can.
Kelly Martinelli (01:26) Okay. You see where it says? Enrollment summary, this box right here? Okay. If Pat and Sonya put the products in here, where can I pull this onto a report?
Lyndsey Farmer (01:43) If they put the products on there.
Kelly Martinelli (01:46) Yeah, because we’re looking for a way because right now we have nothing and it’s we just spent an hour on the phone with authorization. Sure. So.
Lyndsey Farmer (01:52) You can go over to, in the right hand corner next to add enrollment there’s, a little, yep, download next to that, the middle one, yep.
Kelly Martinelli (02:04) Oh, and I can just download my report like that. Yep. If it’s there. Okay. Got it. Okay. Thanks for letting me hijack the meeting.
Lyndsey Farmer (02:11) Yeah, no problem. Okay. Great. Thank you. All right. I will share my screen and get started.
Kat Rivera (02:21) Okay. I’m going to have Sonia join because she says she didn’t get an invite. So I’m going to send it again. Oh, I think she’s on it’s. Okay. Don’t worry, I’ll send it to her.
Lyndsey Farmer (02:30) Got it. I will make sure that she’s added to this. I thought she’s added to all of them, but.
Kat Rivera (02:35) actually, let me check. No, she wasn’t added to this one but it’s okay. We’re going to send it.
Lyndsey Farmer (02:39) I’ll put it. I’ll put it, make sure I put her on there. I apologize. All right… share.
Kat Rivera (02:49) Okay. So.
Kelly Martinelli (02:51) We had, we’ve had an issue in the last two weeks where we were asking for updates and we were told that they don’t do any follow ups that they only do it from start to finish. So, Lindsay, we were having a, we took, I had to take everything back.
Lyndsey Farmer (03:09) Who you were being told that by support?
Kat Rivera (03:12) Yes. Yeah. Let me, I got the same.
Kelly Martinelli (03:16) Answer as Kat did. Yeah.
Kat Rivera (03:18) So we did a test, remember with the update regarding entering the follow ups for prior. So internally, we did the applications and then we forwarded over the follow up excel spreadsheet to madaket when we first started in October, and then we re forwarded it again. So when you gave me the update at the ending, of March, I believe or almost April, we did a test to confirm if we can get the update from the support. And she, they said they couldn’t give us any information on that. So we took it back and we, regardless of the matter, we do follow up because we, you know, get emails, and approvals through our credentialing email box, but medallion wouldn’t be able to give me an update on the outstanding items even if I put it in as a like a medallion request, follow up, and give the name of the provider. So we just took it back in house. And this was the last.
Lyndsey Farmer (04:18) one. I will follow up on that as well. Perfect.
Lyndsey Farmer (04:35) Okay. Yeah. I’ll follow up on that one. Sure. All right. So as far as Ryan Foley goes, that was sent back to the team to do some retraining on. I do apologize that was sent to you all for the wrong provider.
Kat Rivera (04:52) Okay. It’s still in there. Okay? So I just keep saying, you know, wrong provider. So I’ll just leave that out there yep.
Lyndsey Farmer (04:58) I will get back with them again today. I sent that back to them last week to do some retraining so we’ll follow up with them as well. On that one, for the support ticket where the providers were uploading that diploma or you all were uploading that diploma, but it was being rejected. The tech team closed that ticket. So, please let me know if this continues.
Kat Rivera (05:23) Okay. I have to, I have to test it. So I’ll test it today.
Lyndsey Farmer (05:26) Okay. Yep. Let me know with an example if it, if it’s continuing, if you could just send me an example of the provider you’re trying to upload it for, and then I can take it back, and have this reopened. Looking at you guys at the platform. It looks like you all have 10 outstanding tasks?
Kat Rivera (05:48) So, if you want to share your screen, those tasks that show in, there are either cois that have been done and we have answered on them. So I can go in there and show you.
Lyndsey Farmer (06:02) Can you see this?
Kat Rivera (06:03) Yes. So, this one was just added today. So, org… give me one second. Why would that say missed? It wasn’t there missed five days. What does that mean that’s? Just the, that task note wasn’t?
Lyndsey Farmer (06:17) Are you talking about the Sierra rubenstein, or Christina michaud?
Kat Rivera (06:21) Let’s go to Sierra because Christina michaud that just came in today. Yeah. Okay. So, let’s go to, Chris, yes?
Kat Rivera (06:34) So, this is the problem I’m having with these type of enrollments when they’re sending this over to us. We’re stating and there’s examples in there, we’re stating to them that we do not take medicaid. Okay? Someone like her, she’s an old provider and she’s already been enrolled in ascension care. So we say she is enrolled in ascension care. If, so, please add an existing enrollment. She’s been enrolled for multiple years. And if we don’t have that enrollment, if not, please submit a new enrollment. So they’re not actually if we respond back and say this provider is existing because it shows on the payer side, are they comparing to see? So this is this?
Lyndsey Farmer (07:17) Is asking for a group enrollment? Not a provider enrollment? So.
Kat Rivera (07:22) Ascension care management is a ipa, and it’s done on a, it’s done on a individual level under the provider linked to a group. So it’s different than a regular payer?
Lyndsey Farmer (07:40) Okay. All right. Let me go back.
Kat Rivera (07:43) And if you go to like a couple of them, I can give you… Kelly, do you hold on a second? Kelly? Do you remember which one it was that they asked for? I think it’s Dawn if you go into Dawn. So… and you go to my notes, you will see my notes saying we do not accept medicaid. Okay, this group is remote proceeding this weather. The group is currently in walk in currently in existing enrollment. So that’s my worry. So, and correct me if I’m wrong, what I see happening is they’re looking to see what the provider’s not enrolled in. And then they’re sending it to say we need a medicare. We need a medicaid enrollment to add this provider. When we don’t take medicaid. And we’ve said that from the time that we did our import into the system that we did, and we still are getting that product of medicaid when we only do medicare. So the provider gets enrolled on the medicare component side, right? And then that’s how we get our group enrollment. But we keep saying medicaid. I just put it in the other day. I was showing Kelly like providers enrolled with medicare component, psa does not service. This is what I keep putting, please confirm with the payer status and the effective date that’s why we have, you… know, that task given to them. So I’m not too sure if maybe how, you know, what’s the back end of it. So I don’t know what they’re doing or looking at to come up with this medicaid enrollment payer. And if not, please open up a new enrollment, you know what I mean?
Lyndsey Farmer (09:25) Okay. Yep, let me, I will put this.
Kat Rivera (09:29) Yeah. As an example. And then what’s happening after that, Lindsay, they’re closed when I say, please close like if I say please close request, they’re closing the request of not following up with it versus finding out the status of it. So… they’re putting it as a closed enrollment on the, you know, on the provider payer profile section and they’re not actually doing the full follow up portion of it if you understand what I’m saying, yeah.
Lyndsey Farmer (10:07) I’m going to take this back to our operations team as well.
Kat Rivera (10:45) Okay. I have something to add. But when you’re done go ahead. So for the caqhs, so when the provider gets onboarded, you know, how they get the invite, letting them know and then they’ll fill out the profile, you know, and either we’ll upload documents or they’ll upload documents, whatever the case is. When it’s time for… the medallion team to go into the caqhs, they’re not listing out like phone numbers and information, accurate information on the caqh. So how are they maintaining our caqhs? Are they, when you say maintain, are you guys like adding locations and, you know, making sure that everything’s in a timely fashion by date or are you actually updating the actual software that’s the proview software with information if it’s missing?
Lyndsey Farmer (11:39) Sure. So whenever there is a change for a provider, they will go in and update that. So such as like diplomas, expirations, cois, things of that nature. We will go in and update. And then we also do the reattestation every 120 days.
Kat Rivera (11:57) Okay. So then if there’s a wrong phone number in the caqh, then that wouldn’t be them adding that in it’s probably the provider. Is that correct? Okay. All right. So I will have to look at that also. So Kelly, just to give you a real quick insight, let’s say we have a new provider. The phone numbers or some of our like zip codes are where we notice that we’re incorrect in the system. So we’ve been going through the back end to do that. So we’ll just confirm who’s doing that change in the system for us to make sure that it’s okay? Because it’s going to be an issue once we put in the system and we have inaccurate information on the billing side. It’s going to be an issue if caqh is not set up correctly. So we will have to review the caqh for the provider before entering a task for medallion to do on our end. So that will be an addition for us to do. Okay… I can show you later on so you can see.
Kelly Martinelli (13:06) I think I can get that one.
Kat Rivera (13:08) Okay.
Lyndsey Farmer (13:14) Okay. And then looking at your applications in process, we have 52 applications that are currently in process.
Kat Rivera (13:26) And.
Lyndsey Farmer (13:27) it looks like you guys just requested two today.
Kat Rivera (13:31) Okay. Yes. So that’s so we were trying to, we were trying to enter the information to add on for ascs. And we, when we submitted that the information, it wasn’t populating. So, I went back again today to confirm because it’s only going to two locations. I see that it’s going in as a, I want to do it as an address add and it’s giving me it’s giving me a full enrollment add. So, is that going to be an issue?
Lyndsey Farmer (14:03) Are you able to select change of information? Well?
Kat Rivera (14:08) It wouldn’t be a change of information. It’s a new location, and the way we presented it to the payer is as an address add. So is there a different way that we should be submitting it to medallion? No, it’s only five. It’s only five. It’s only five of them.
Lyndsey Farmer (14:27) Okay. No, that is the correct way to submit it in yep.
Kat Rivera (14:32) Okay. No problem.
Lyndsey Farmer (14:36) And you have?
Kelly Martinelli (14:36) Three more to add to that? Is that, is that what I’m hearing?
Kat Rivera (14:39) Yeah, because one is one, but one is going to require like a four step and that was one of the last questions we had. One requires when you submit it, the request, you’re going to get an MD application, and then the application needs to be submitted to the plan. And then the plan will give you authorization to go in and start the credential because it’s done online. So, that was one of the questions we had on our last meeting. Lindsey, how will we go about that? Sonia asked that question?
Lyndsey Farmer (15:15) Okay. Can we go? All right. Let’s go back. So, we’ve, got two in process and we’re adding three more, but one is a four step process, correct?
Kat Rivera (15:27) It’s a three step process.
Lyndsey Farmer (15:28) Three step process. Okay. Let me… all right. So adding five new locations or addresses?
Kat Rivera (15:41) Address, we’re adding the same, we’re adding one address to five different contracts. It’s under the same tin number, but different mpi.
Lyndsey Farmer (15:52) Five tins. Yeah. Okay. Two already have been requested… three more to come. So.
Kat Rivera (16:08) It’s not five tins. It’s five payers being… added to one tin number, but a different mpi number?
Lyndsey Farmer (16:17) I’m sorry. No, it’s fine to one tin. Yeah.
Lyndsey Farmer (16:26) It’s five payers… to one tin for five payers. Correct? Yeah, under.
Kelly Martinelli (16:36) One tin under one tin, and you said different mpi number? Kat?
Kat Rivera (16:40) One, yeah, and, the group mpi is different than the original, so that’s how we separated it out. We did it under the same tin number so that the contract could be the same and we can bill it out. But the mpi is going to drive the address, and that’s what’s going to be added like linked to the contract. And.
Kelly Martinelli (17:02) This is lakeline. Right?
Kat Rivera (17:04) Yes, that’s right. Is.
Kelly Martinelli (17:06) It called cedar park or something else. It’s.
Kat Rivera (17:09) called lakeline. That’s what Julie wants us to call it. Lakeline. A S. E.
Kelly Martinelli (17:15) But is that the, that?
Kat Rivera (17:18) Is the cedar park? Yeah.
Kelly Martinelli (17:19) That’s the problem. Make sure Lindsay knows the, what we’re calling it, what the actual name is?
Kat Rivera (17:25) Yeah. So we have it in there as… cedar park too. I believe cedar park.
Lyndsey Farmer (17:33) Yes.
Kat Rivera (17:36) Okay. It’s under the facility under the facility component, if you want to put in parentheses, two, two, one eight, because that’s the, yeah, that’s the address two two, one eight. Okay?
Lyndsey Farmer (17:50) All right. One being a three step process, yes.
Kat Rivera (17:56) That’s the one we need to make sure… it’s very silly. They make you send the email just saying, hey, this provider wants to get added to your network and then they send you a link and then you’re supposed to fill out the link. And then once you fill out the link, they actually go ahead and send you the actual application via link. So, I want to know how we’re going to be able to track that because that profile has, I believe it’s like 14 payers. So.
Lyndsey Farmer (18:29) Is that and correct me if I’m wrong, this three step process, we send an email, we get a link and then we fill out the application that gets emailed.
Kat Rivera (18:37) To us?
Lyndsey Farmer (18:38) Okay. All right. Perfect. So.
Kat Rivera (18:42) Let.
Lyndsey Farmer (18:43) me ask… my thought process is that we would track it in medallion… because it would be, it would show up in a second. Let me get it back up here. It would show up just like this one, just like these ones, so we would be able to track the progress of it here.
Lyndsey Farmer (19:27) Does that make sense? Yeah. Okay. Perfect. Yeah, once it gets requested, it will come, it will be here and then it will move into processing once obviously our team takes it and starts to process it. So then it will funnel into here and look like these ones. So we’ll be able to track when the follow ups were done. If anything’s needed all that.
Kat Rivera (19:58) Okay. I don’t want to interrupt you, but Sonia said that she’s waiting says waiting on host. Oh, sorry. You see that’s? Okay. I got her.
Kat Rivera (20:20) Okay.
Lyndsey Farmer (20:22) And I’ll be sure to relay all of this to the team as well.
Kat Rivera (20:28) So.
Lyndsey Farmer (20:30) That they are understanding of what is to come?
Kat Rivera (20:37) Okay, perfect. And you will always, if you get an answer before you’ll send out an update, correct?
Lyndsey Farmer (20:42) Correct. Yep.
Kat Rivera (20:46) I don’t have anything else on my side, Kelly, do you have any other questions?
Kelly Martinelli (20:51) I don’t okay. I,
Lyndsey Farmer (20:54) didn’t have anything else on my end today. I wanted to just share with you the applications that are in process, the outstanding tasks that I will be taking that back so that we can do a deep dive into those tasks. Yes, can.
Kelly Martinelli (21:09) We go back to what still needs done on our side for the administrative tasks in medallion since we only touched on one.
Kat Rivera (21:16) Yeah. Okay. Yeah, that’d be perfect. You can go down the list. So, so it.
Lyndsey Farmer (21:26) doesn’t look like, let me go to admin tasks. That would, so you guys have nine in admin tasks, but Sierra and Dawn, I’m taking back, yeah.
Kat Rivera (21:38) Well, if you go through the list, you’re going to see more that you’re going to need to take back.
Lyndsey Farmer (21:43) So, this one’s a demographic update.
Kat Rivera (21:45) So, this one is a demographical update, but it says ticket has been submitted to Lindsay to see why not. Remember. It was adding. It wasn’t letting us add under the group profile, all three entities. Yes, under the profile, you were going to see why it wasn’t allowing us, I don’t know if… yep.
Lyndsey Farmer (22:03) I will take this as an example and send it over to the tech team as well. Again, I’ve already done that. No.
Kat Rivera (22:09) Problem that’s fine. I’ll send it again. If you go through all the notes there’s, notes listed in there and questions that we have. Okay?
Kelly Martinelli (22:21) There’s one on Arthur Boyd.
Lyndsey Farmer (22:24) Arthur Boyd.
Kelly Martinelli (22:25) Because Kat, looks like she addressed all the other ones. So they’re sitting with?
Kat Rivera (22:31) Yeah, but you know what it is? This one is, right. Kelly, this is out of the scope. He has to go in and put the date and he hasn’t done that and we requested it multiple times to him. So I can get the manager to get that taken care of. That’s. Nothing big on our point, but the rest of them, if you go through them one by one, you’ll see some notes that I added in there. Yep, you know, and so, why? So.
Lyndsey Farmer (23:00) We did her this one?
Kat Rivera (23:04) What do you need from dr. Boyd? We just came to his profile. If he can go in his medallion profile and go under the caqh as a station and just date it. That’s all I need Jeff. Okay. Yeah, it’s very simple. No problem. I’ll get it done today. Okay. You got it.
Kelly Martinelli (23:23) Thanks, Jeff.
Lyndsey Farmer (23:25) It looks like this one you answered, Kat. So I’ll flag that to the team.
Kelly Martinelli (23:33) It looks like they’ve all been answered. Yeah.
Kat Rivera (23:36) But this is the complete, right? This is the complete side or it’s just the,
Lyndsey Farmer (23:40) no, this is for ready.
Kat Rivera (23:42) Okay. Gotcha. No problem. Yep. So.
Kelly Martinelli (23:44) Can I look at the, dr, Jessica arias?
Kat Rivera (23:50) Jessica arias… dr arias is the one for dr arias. She just, she needs to do the same thing and sign and I already wrote to dr arias and told her what she needs to do. Okay. Yep. Okay.
Kat Rivera (24:12) Christina machar came in today, and she probably needs to be assigned to locations that’s fine. That’s internally that’s what we can do. I can do that. That’s easy.
Lyndsey Farmer (24:28) Ryan Foley. Yep. This one’s already been taken back.
Kat Rivera (24:33) Yeah, that’s the one that was wrong?
Lyndsey Farmer (24:34) Yep. This is another one that needs the three.
Kat Rivera (24:45) Yeah, that’s another one with that example to be tied to?
Lyndsey Farmer (24:53) Another one. Yeah.
Kat Rivera (24:55) Okay.
Lyndsey Farmer (24:56) And then we went through Arthur Boyd, Leah.
Lyndsey Farmer (25:03) And this is a Coi, it looks like you guys are still waiting for underwriting. Yeah.
Kat Rivera (25:07) We’re waiting for that one to come through, so.
Lyndsey Farmer (25:10) A couple on your end and a few on ours that I will send examples and take back.
Kat Rivera (25:20) Okay, great. Jeff, did you have any questions on your providers?
Jeff P. (25:25) Just dr Paris on cigna? Tricare, if there’s even any updates since the last two weeks.
Lyndsey Farmer (25:33) Let’s see.
Lyndsey Farmer (25:46) You said tricare?
Jeff P. (25:48) Yep. And cigna?
Kat Rivera (25:56) Let’s see this one. What does that mean? I’m.
Lyndsey Farmer (26:02) sorry, it.
Kat Rivera (26:03) Said missed something back there. It.
Lyndsey Farmer (26:05) Missed an SLA, it was submitted one day and one hour late. So that’s on our end, the follow up was completed a day later than it should have been.
Kat Rivera (26:19) Oh, okay.
Lyndsey Farmer (26:19) Got it. Okay.
Kat Rivera (26:21) No biggie.
Lyndsey Farmer (26:22) so, it looks like they followed up and this is still in process. A follow up email was sent to the payer regarding status inquiry to get current status on application. Next follow up is in 14 days.
Jeff P. (26:43) Is there any other mode for following up besides requesting sending an email to the payer or is that all they do is just send an email and wait for a response?
Lyndsey Farmer (26:52) So, our methods are portal payer and phone call. I’m sorry, portal email and phone calls. We try each one a number twice, and if we’re not getting, then we’ll move to another method.
Jeff P. (27:07) What’s the time period in between? I’m sorry, what’s the time period in between tries? Like, is it okay? Like I send an email and two weeks later, I make a phone call.
Lyndsey Farmer (27:18) So we try each method twice. So, if, after two times, we’re not getting any movement from the payer, if we’re going without an answer, then we will try another method and that’s per the payer.
Jeff P. (27:34) And I guess my question is, what’s the time period like that before you move on to the next step? So.
Lyndsey Farmer (27:41) Every follow up is 14 days.
Jeff P. (27:43) Got it. So, potentially, it could be like a month and a half before we start calling them.
Lyndsey Farmer (27:52) Depending on the payer, some payers, don’t accept phone calls for follow ups. It really depends on the payer, they have ever since really covid, they have gone more virtual. So everything is mainly done via email and, or portal requests. So we do make phone calls, but that’s in the event that we are not getting any answer at all from the payer, okay? Because.
Jeff P. (28:23) I believe this one, we’re approaching 120 days from the start of the credentialing process. All right. What about cigna?
Lyndsey Farmer (28:33) Yeah, I’m just going back through this one.
Lyndsey Farmer (28:50) So, we got an answer from tricare on April thirteenth. So, there’s more let’s, see.
Lyndsey Farmer (29:16) I can follow up with the specialist on this one, because it looks like there are, there is some back and forth with the payer. So I can follow up with the specialist on this one.
Kat Rivera (29:27) Lindsey, by any chance, do they utilize availity?
Lyndsey Farmer (29:32) We do utilize availity? Okay.
Kat Rivera (29:33) So, there’s a chat function in availity, if they go into the tricare or triwest, there’s a chat function. And if they don’t see it on the triwest side, they give you a tricare number, and then they’ll be able to see it on, that side of if it’s both completed because now they do both of them together. So maybe they, if you can find out if they use that chat function because 14 days is a little bit too long for us, to wait for that. So, I mean, I know that’s your process, but if they can also somehow in between do a, the chat function, or phone call, would that be allowed?
Lyndsey Farmer (30:14) I can take that back and ask, yep, no problem.
Lyndsey Farmer (30:21) And then.
Lyndsey Farmer (30:29) let’s see sigma. Let me go back.
Lyndsey Farmer (30:54) I do not see sigma in his list.
Kat Rivera (30:56) Sigma’s under ascension that’s the issue. We’re going to have.
Lyndsey Farmer (30:58) Oh, I’m sorry. Yeah.
Kat Rivera (30:59) So, sigma’s under ascension with a whole bunch of other payers and Kelly, this is a perfect example.
Lyndsey Farmer (31:09) So, this is waiting on that task that we need to take back Jeff.
Kat Rivera (31:15) Okay, perfect.
Jeff P. (31:20) So, what task? I’m sorry, I don’t know. I don’t know what task we’re waiting on, sure.
Lyndsey Farmer (31:24) We just went through all these tasks. So this one is stating that the group must be enrolled with ascension before the provider, however pain specialist does not see medicaid patients. So I need to take that back to the team.
Kat Rivera (31:43) Jeff to be a little bit more clear ascension health, it’s done on an individual level. So, when they don’t it’s not like a contract. So it’s like, you know, we purchase not purchase, but, you know, how we have a membership with them. It’s more on a membership level. So, what they do is they contract with the individual payers, like cigna Aetna use that as an example, but they tie it to our tin number. So when they process the provider, they process the provider on the individual level, and they just attach you to your tin because of our membership.
Jeff P. (32:14) Yeah. What does that have to do with? What does that have to do with medicaid? So.
Kat Rivera (32:21) What happens is we’re having an issue because on the back end of medallion the workers are, I’m sorry, the team is basically saying that we need a medicaid enrollment to find out a status which is incorrect. So, Lindsay’s taking it back because we only do medicare product.
Jeff P. (32:40) So when.
Kat Rivera (32:42) we enrolled in order for you to enroll, you would need to either have a medicaid business or a medicare business. We have medicare business. So that’s how we enroll. So when we submitting for Ronald Paris, since it was done in house, it’s a follow up status, but we’re getting back, we’re getting back a kickback saying, does this provider have medicaid? So that’s not, you know, that’s not the task is really to find out the effective date and to find out if he’s been linked. You know what I mean? So that’s where the inconsistency of information is, it needs to be followed through? So she’s going to take that back saying psa doesn’t accept medicaid, they only do medicare market and we need to get a status and effective date, not the message you’re sending back to us.
Jeff P. (33:26) So, so my understanding, hold on, I’m driving and there’s a cop getting behind me. So my understanding is that there’s not a problem with the enrollment. The problem with is with the follow up on the enrollment that.
Kat Rivera (33:43) is 100 percent, right? Yes. And.
Jeff P. (33:45) So, what does it take to get somebody to follow up on this? You know what I mean? Cause I can’t see six. I mean, he might be potentially credentialed, but in this group and I’m holding off on seeing patients, correct?
Lyndsey Farmer (33:57) You can’t see patients right now.
Jeff P. (33:59) But, he may be enrolled right there’s a possibility. We just don’t know I.
Kat Rivera (34:05) Have an answer to that question.
Kat Rivera (34:07) Okay, Sonya and I have taken back until this is resolved with medallion. We’ve taken back our follow ups that we have done internally and we always Jeff get the email from ascension saying if the provider is effective or not. So, regardless if medallion is working our internal follow ups, we internally are still getting those emails and we are internally getting those follow ups regardless. So there’s not going to be a hiccup in process. So.
Jeff P. (34:31) When was the last time we got an email from them regarding this one? We.
Kat Rivera (34:35) would need to do the research and we can send you that in the email after this meeting.
Jeff P. (34:38) Please, I’m just curious to see when was the last time they sent us the email? So I can better understand the cadence that they’re sending out those updates.
Kat Rivera (34:49) No worries. I’ll send it to you after this meeting.
Jeff P. (34:51) Okay. Those are only two I was inquiring about, right?
Kat Rivera (34:54) Now, so just to give you a bit of an update as well, we just took this back this week because me and Kelly spoke about it on Monday. So this process of internally taking it back is happening this week, but I’ll give you those dates, okay?
Jeff P. (35:07) All right. Thank you.
Kat Rivera (35:09) Got it… all.
Lyndsey Farmer (35:12) Right. So I will take back the takeaways from my end. And if there’s anything in between, please don’t hesitate to reach out and I will follow up with you all as soon as I can with these takeaways.
Kat Rivera (35:28) Okay. Thank you. Perfect. All.
Lyndsey Farmer (35:30) Right. Thank you. Have a great rest of your day you.
Kat Rivera (35:33) Too. Bye.
Kat Rivera (36:18) We don’t enroll facility locations, right? Is.
Lyndsey Farmer (36:24) that the service facility location?
Kat Rivera (36:26) I do leave that one.
Lyndsey Farmer (36:28) So you have a and F.
Kat Rivera (36:30) But I.
Lyndsey Farmer (36:33) don’t think it matters if you have a P or an a, just the facility locations is the.
Kat Rivera (36:47) Kathy does anything impact you? Yeah.
Lyndsey Farmer (36:50) I’m thinking through this because the way we’re structured and delegated right now, if… we have the states where we are required like Florida, Tennessee, California, of course, there’s no business in Mississippi or New Mexico, but those are the states that require the site assessment. We currently base that off of the primary location for that provider. So, let me ask you this, Kathy, with that in mind, if we were to go to the model that we’re proposing today, could we select the location from the list the providers associated with to pursue the site assessment? Because the way this is structured, okay? The way that delegated is structured, we print, you know, we have to go to corporate to print the training reports so that we could get the location for the provider that we’re credentialing that provider for, and it is always based off of primary state. Okay? So that’s what prints on… that report? And that’s how we credential that provider is based off his primary state. Do you like credential?
Michael (38:05) Every location?
Lyndsey Farmer (38:07) Or?
Michael (38:08) Do you, so you just do we?
Lyndsey Farmer (38:10) Just do the. Okay. So I’m in Florida and I’m in six locations in Florida, right? Primary site. It’s the only thing we’re concerned about that’s what we credential all the other locations in Florida that’s null and void. They’re all in the same state. But when you start crossing state lines, and you have a provider that’s in Florida and Tennessee, and all of this, every provider has to be credentialed based on the requirements for that state. So in Tennessee, it would be a primary site in Florida. It’s a primary site in Georgia. It’s a primary site from.
Michael (38:42) From.
Lyndsey Farmer (38:43) our perspective, so.
Michael (38:46) But does it matter if it says primary or just a site? Because if it’s in Tennessee, you know, you’re going to have to do another site assessment, right? Just.
Lyndsey Farmer (38:56) From that perspective, it doesn’t matter. I have to credential in all states irregardless, and the thing, is that, are you going to be able? Yes, I have to think through this because… those locations are added at different times, right? So, I’ve got a provider in Florida and he’s there today. So next week they’re going to or next month or next year, they decide they’re going to put him in Tennessee. So I have to do that location, but it’s in between the cycles. Basically, he becomes an off cycle, yes, which is the other issue that we will need to meet with the CPC about. I don’t know because they all have those locations, all have different dates and they’re not all done at the same time. Kathleen. I have a question you were saying that you were getting something from the CPC, is that, so you’re going through Symplr for that? The way this was set up years ago, there was what they, the CPC created what they call a credentials tracking report for us that’s how we get the primary site. Basically. Okay. So… nothing in Symplr will actually change with any of this. If that helps. It will just be the way we say it in artiva. So you use those tracking reports to identify the primary state. Yes, we do it does. I mean it has no bearing whatsoever that it just gives us the primary location of the provider providers, npi and a specialty. Basically. And if the CPC assigns flights, as long as you don’t disrupt that structure from a credentialing standpoint, I think we’re okay. It’s… just… I still have to be able to capture those sites when those providers get added to those additional locations. And if you’re taking that today, is that just through that tracking report or no workflow, there is, there’s a report that generates every the delegated analyst generated every Monday, Tuesday or Wednesday, whichever day I get it. And after they review the inventory, they basically tell me that, hey, this providers been added to… this group here. You know, let’s say centennial heart. He’s in Florida. So that means I have to go look to see what we need to do to move them forward. A lot of times I get from an urgent care perspective, there’s always a heads up email that says, hey, this providers joining this group, you know, he’s in Florida. But now we’re going to add him to northern Virginia care. Now, can you process, but they’re the only ones that do that. The other it’s just hit or miss as we find them because there’s no… there’s not a good way to catch this except through that PSG report that comes whichever day the analyst sends it to me. And I.
Michael (41:58) remember this being a point of frustration when… I was an account manager. I remember.
Lyndsey Farmer (42:08) It is, it’s very difficult, right? Because PSG was structured. It’s not structured like the commercial payers are that they get an ect request that this tax id has been added or this location, it was never structured that way because we don’t always need to credential every location there is. It’s just really the primary site per state. So, is it the provider’s credentials in that state? Yes, it’s in that state. It’s when they’re entering a new state that it becomes an issue. Yes, if, yeah. Okay. Correct. Okay. So, state, and if they have multiple locations within the state that they’ve already been. Yeah, it’s a delegated process. It’s so if there’s new locations that’s not a trigger current state for the delegated teams. Yes, we don’t need to say, you know, they’ve got two locations in Florida. Now, they’ve added three more. From our perspective, I’m good to go. He’s already been credentialed under that in that state. Okay. Yeah. So really the issue Kathy for your team is the ability to know when a provider has been added to a brand new state. Yep, that is what it boils down to for us. Yeah. And if, the a’s go away, we may have to restructure some workplace… to your new state. Not necessarily a new location with it, correct? Yeah. Also, would you like to share with the group? Sorry?