Transcript
Jennifer Mikel (00:00) yes. Did you color your hair? Did?
Collette Waddell (00:02) I color it? No, it’s just the.
Abby Gonzalez (00:04) Lighting? Oh, I,
Jennifer Mikel (00:05) was like it.
Abby Gonzalez (00:06) Looks good.
Collette Waddell (00:07) It’s wet because I like squeezed in a five minute shower earlier. And then that’s all I had time for. So… they’re in the waiting room. So I’ll go ahead and let them okay?
Collette Waddell (00:30) Hi, Abby. Hi, Adriana. Hi, Joanne.
Abby Gonzalez (00:33) Hello. So sorry, my zoom always opens on mute.
Collette Waddell (00:41) Yeah, I think it defaults to, for attendees to do that. Hi there. Hi, hi, Jillian. Jillian. I know we briefly met earlier this week, yeah.
Collette Waddell (00:53) but if you haven’t had a chance to meet, Jen, is our public, excuse me publishing team, the manager of the team who focuses on the appointment files and things like that. So, and I know we weren’t able to have Jen join us. She had a conflict on our, during our call time earlier this week. So, we kind of just created a, another 30 minute block just to kind of run through the appointment specifically.
Abby Gonzalez (01:19) Okay. Sounds good. Thank you. Yeah.
Collette Waddell (01:22) No worries. And forgive me, I did not update the agenda because this was like a different meeting, but we can pull up.
Abby Gonzalez (01:35) Yeah, I went, I added my notes to that agenda. Okay? An ongoing agenda that we use.
Collette Waddell (01:43) Yeah, yeah.
Collette Waddell (01:51) Jen, I’m gonna screen share here in just a second. Let me get pulled up. Okay? And then we can just kind of run through these…
Collette Waddell (02:09) Let’s see… do you see this? Is it good? Yeah. Okay. All right. And,
Abby Gonzalez (02:18) real quick. Also, Jen, I don’t think I mentioned, I don’t think we had a chance to talk about Jillian’s role joining stem. So she will be assisting in the oversight of the appointments piece. So, a lot of the communication right now that you see coming in is from me, but that will transition into Jillian sending that over for the appointments. She is going to be assisting with processing those and making sure that the applications are complete prior to your team beginning working on them. So, like the provider profiles, we have turned off the auto reappointment, so that way, when these files are assigned to your team, we’ve confirmed that we checked everything on our end and your team shouldn’t have any issues processing the file. Very good.
Collette Waddell (03:24) All right. Do we just want to start from the top?
Abby Gonzalez (03:30) Or we can go ahead and go to the top. So, for this provider specifically, we are pending further information from our team on whether or not this physician is going to be moving forward with them. So we have peaked at his file, but there are still some questions. So we’re not ready for that file to be moved to committee.
Abby Gonzalez (04:07) And then down on to dr buchowski, we are pending some information from this provider in order to complete the profile. Let me pull it up. Thank you.
Abby Gonzalez (04:52) Okay. Just confirming that dr buchowski is one of the providers that we’ve reached out to for some items that we need in order to proceed with his reappointment?
Abby Gonzalez (05:10) And we are trying to get this information back from dr buchowski by Monday. We’ve made a couple attempts out to him to request the items for his reappointment. And so right now, we are pending him to get those items back to us.
Abby Gonzalez (05:32) And then for dr… kipview, let me go ahead and pull up this provider’s profile.
Abby Gonzalez (05:47) Okay. So for dr kipview specifically… I guess I’m just not understanding the workflow of the team because for dr kipview, it says that he, they’re pending him to provide some information to the profile, attest to the profile, so they can proceed. So he attested to his profile on April the second. Do we know if that, the one peer that was in his file has been sent out? No?
Jennifer Mikel (06:19) It hasn’t because we are waiting for him to populate all of them so they could go out at once. Okay?
Abby Gonzalez (06:25) So, I think that we can definitely send this one out. That is in the profile. We are required to obtain the three. But if he has attested to the profile, then I think we should be able to attempt to send that one out while he is working on gathering the other information? Because I see here that we have gone in and fixed some of his professional history and also attested to the profile. And so we saw that had not moved forward. So that was one of the questions for us is if that had been sent?
Jennifer Mikel (07:06) No, because we are waiting for all of them to send them out at once.
Abby Gonzalez (07:10) Okay. So with one, they’re unable to send that out, no?
Jennifer Mikel (07:15) We can, but we would just like, so we’re not going back and just making sure we’re not resending it to the same people. It’s just easier if we have all the information in there to send it. So we can go back and just follow up on those references versus going back and double checking on when they add them. So, I mean, ideally, we would like to have everything done. So we can just, you know, the process is more streamlined because just waiting, I’m sorry, going ahead and doing it on one offs can get sometimes confusing if we have multiple people trying to touch the file and help. And that’s why, ideally we would like to try to have the profile kind of complete in this information, right?
Abby Gonzalez (08:00) So, we wouldn’t be assisting, with the appointment piece, and that would be good for, to bring to these calls. So if we assign the appointment and we have only one peer reference in the file, I think we should be able to proceed with that and bring it to the table on our weekly cadence to say, dr tipu has provided us with the final references for his file. We’re going to go ahead and add those in there. If you can have the team reach out to those two additional ones if I mean, and when we get those, we may have the one that comes back, but I think that we can go ahead and start that and we can bring the communication to the calls to say the provider has added additional information… okay?
Abby Gonzalez (08:56) And we can make, you know, the notations on here on this spreadsheet and… we’ll discuss them weekly.
Abby Gonzalez (09:38) And then,
Abby Gonzalez (09:45) go ahead, you can, I see that you’re notating there? I was you?
Collette Waddell (09:50) I’ll just be the note taker so you can move forward and I’ll just finish just adding the notes about what we just chatted about here.
Abby Gonzalez (09:58) All right. Okay. And then for dr childress… we did not find the communication in the platform regarding the suspension. So if the medallion team reached out to the facility to obtain an explanation, we should be adding that to the file. So that way we can see and that we have visibility to see that the medallion team has already proactively tried to obtain a response rather than putting the verification in there, flagging it as a red file. But we don’t have all the details.
Jennifer Mikel (10:39) Okay. Yeah, we can. So we don’t have like a questionnaire sheet or a verification sheet for anything like that. So I can drop one in there and create one. When we have a red flag that would be attached to the verification, right?
Abby Gonzalez (10:57) So, we’re not, it’s not a specific form, but was it an email that was sent out to the facility or was it a phone call? It?
Jennifer Mikel (11:04) Was a phone call to find out if they would release it by email or what we would need to do to get the information regarding the suspension?
Abby Gonzalez (11:14) Okay. And most likely, it could have been because of an authorization form. So, if you can, I mean, and it can be something as simple as on a word document just putting on there when you called, who you spoke to, what they told you. So that way we have it documented to say that you obtained a verbal from the facility in regards to the suspension. And when we review it as committee, then we would take further action.
Jennifer Mikel (11:41) Okay.
Abby Gonzalez (11:44) So, but I just want to make sure like moving forward that that’s something that we can do because we want to make sure that when Jillian comes in to view the files or I come in to view the files, all questions are answered rather than having to come back and ask, like, did we do this before creating a task in the platform?
Jennifer Mikel (12:08) Well, a task will be created for this because it’s a red flag.
Jennifer Mikel (12:15) Okay. So you would automatically get a task for this because that’s our documentation letting you know that there was a suspension and we’re notifying you of this. So it’s like flagging it because let’s say we didn’t do that, then you could come back and be like, why didn’t you tell us? So that’s our way of notifying the admins that there’s an adverse, you know, discovery on the file. And so that’s why you were given. And like as soon as we found out about the suspension, we sent the red flag. And then we made the phone call. And so our next step was going to be and you had already emailed back before I could get back to you. Because the notes in regards to that was already sent to me about the provider would need to provide that information to us. So you had already responded to the task. So it kind of right?
Abby Gonzalez (13:09) Okay. But in the task also, there was no notation indicating that you had already reached out and you were pending further response from the site. So it was good to see the task. But then I also noticed that the task was created and the file was sent to committee. So we just wanna make sure that we’re reviewing the files before they’re sent to committee. So that way we can discuss this. And if there is a red flag, I think that it’s important to notate the action that is taken when the verification is pulled and it’s identified as derogatory.
Jennifer Mikel (13:44) Okay. Yeah. So we can make that transparent to you versus it being just internal for our records that’s completely fine. I’ll come up with a system for you.
Abby Gonzalez (13:53) Okay, great. Because we would definitely need to be able to see that. Okay? Now, the thing with that also is because it has been moved to committee, it… won’t be part of the file, but we’d still be able to see it in documents.
Jennifer Mikel (14:12) So none of the task information would be part of the file. And so would you want this information attached to the verification? Yes?
Collette Waddell (14:26) You would, yes, well, let’s clarify real quick what information you want included or attached. So.
Abby Gonzalez (14:34) The information that would be attached would be the explanation from the site. So if there, so if we prepare a file, we would still be able to add. So if Jen at this point already has all of the information from the site, then she’s able to create that document and attach it to that verification to say, yes, it was suspended. But we confirmed this information. It just makes it a little difficult because it’s already been moved to committee. So that document wouldn’t be attached to the PSP. But in the end, we want to be able to see that if the medallion team obtained a primary source verification and it said suspended, there should be something that follows that to say medallion reached out spoke to so and so confirmed this information or was unable to confirm, yeah, like.
Collette Waddell (15:29) A page two of the verification document that has that like addendum?
Abby Gonzalez (15:34) Right, right. Because then we see the suspension and we’re kind of like, okay, why was she suspended? Did we, did medallion ask that question? You know, same thing we’re asking our board is going to come back and ask us, right? Yep.
Collette Waddell (15:49) Okay. I just want to understand. I just want to make sure we were clear on, what you were hoping to see in that attachment. Yeah. And so, for, since this file’s already moved forward, this is going to be a process that we’re going to implement moving forward for other instances, right?
Abby Gonzalez (16:07) Yes. But once we, but once, because Jen has the verbal information, if she can add it into the documents into.
Collette Waddell (16:16) The document tab, yep, right? Yes.
Abby Gonzalez (16:18) That’s where the committee will go to see the documents that might have been added once that file was moved to myview?
Collette Waddell (16:26) Perfect. I just want to make sure that we were clear on what the expectation is for dr childress’s file and then moving forward. So, thank you. Yeah, yes, perfect.
Abby Gonzalez (16:39) And then that kind of ties into one of the questions that we had Jen in regards to the updates in the notes section that the team utilizes. So I noticed that the notes in that section are not consistent. So the team will notate so many hospital verifications and peer references. And then the following note will reflect those items fall off. So it looks like we’ve received them, but in fact, we haven’t so.
Jennifer Mikel (17:14) When it gets moved, so like everything for her file was received except for now, we’re needing this explanation for the suspension. So the notes wouldn’t be updated. It’s only going to be for while we’re processing it. But once everything’s received, we don’t make another note before we move it to ready.
Abby Gonzalez (17:35) Right. So on March the seventeenth, the file was on hold for pending additional information in the notes. It says that they were pending additional references and it was tasked to the provider. On March the nineteenth. It said that they’re pending three peer references, they were sent on 319 pending claims history, hospital affiliations, and then the work history, which we then clarified the work history. But then on 326, they went in and noted that there was a hold reason pending additional information, note, current malpractice task sent to provider. So then from 319 to 326, those peer references fell off but had not been put into platform until just this week when we received it. So.
Jennifer Mikel (18:22) The person that is working. Okay? So the person that put the 326 note in should not have put the note in. She, she was not given the file. She came in. We have a new intake department. She came in and started reviewing everyone to make sure that they were like compliant or at 100 percent. And so I had to actually go back and talk to her about if it’s not assigned to her. She doesn’t need to be sending tasks. So that was a whole… like she sent a lot of tasks out that wasn’t supposed to go there. So that’s a completely different person that was not even working the file, who should not have sent anything. Okay?
Abby Gonzalez (19:07) So then moving forward, we should see consistent notes reflecting if a verification is received. We should find it like in the document section.
Jennifer Mikel (19:18) Yeah. And so like I, so Daniel got pulled over to something else. And so I’m going in and I’m processing your files right now. And so if you look at them, so like st Joseph’s university of El Paso, the things that were pending, we were able to pull, I was able to get those done after you provided the peer reference.
Abby Gonzalez (19:43) Okay.
Abby Gonzalez (19:52) Okay. So then technically, there would have been another note after 319 from either you or Daniel who was, might have been working on the file at this time to show what you had received up to that point.
Jennifer Mikel (20:07) Correct. Okay.
Abby Gonzalez (20:09) That’s one of the things that we just wanted to make sure we weren’t aware of the internal changes and that there was another medallion agent documenting. So that just caused a little bit of confusion on our end especially for Jillian coming in as one of our new specialists. When she, when we pulled up the platform together, we noticed some of these things and, you know, that’s where, we were kind of questioning each other. Like, so did they receive the peer reference or had they not because the tasks were just not reflecting what we were looking at in the platform? Yeah.
Jennifer Mikel (20:48) So that was, I had to go in and do some additional training on the like if it’s not assigned to you, don’t be going in and putting notes or changing things because you are changing the workflow. So that was a whole part of itself. So, yes. And that’s why there there were not supposed to be those notes.
Abby Gonzalez (21:09) Okay. Got it. So then we will, I’ll note.
Jennifer Mikel (21:14) That out because Daniel already had what he needed to process the file for that because of the type of file. It was right? Because I believe it was a it’s a reappointment file. So technically the information that was requested was not necessary for the file. Okay? And it was already in there. Like I think Daniel had already sent a task about it. So it was just duplicate tasks for the provider. Okay? For clarification. So that created confusion as well. So I had to do a whole re education on like, you know, looking back at other notes and other tasks and making sure that like you’re only working things that are assigned to you and that kind of thing.
Abby Gonzalez (21:57) Okay. And then to add to that also… how is your team able? Like how can we try to fix the peer reference issue? Because also… there hasn’t been a note in the platform since 319 and we were looking for updates. So I’m still looking at those at the platform to be updated on Friday, but I’m not seeing that. And one of the things is with dr childress’s peer references, we noted that the peer references had not been replying, but one of the peers did come back and say that she did reach out to medallion. So.
Jennifer Mikel (22:49) I wonder if she did like com because we don’t have any emails from them. That’s why I was asking which email they were using because Daniel didn’t have any responses. So.
Abby Gonzalez (23:01) When Daniel goes into the file to review it weekly, how is he checking for updates to see if a peer has replied? And is it being sent out, you… know, like on a weekly cadence?
Jennifer Mikel (23:16) So, for references? So Adobe automatically sends a reminder to the provider or whoever we sent it to, letting them know that they still need to sign.
Abby Gonzalez (23:28) But there’s no way for your team to see if the provider had issues on their end.
Jennifer Mikel (23:33) I don’t think there’s a note section, not in like our part of Adobe. It’s not like DocuSign where you can put notes in and send it back to the originator. Yeah, I,
Abby Gonzalez (23:47) noticed that there isn’t a receipt for those peer references that are coming back so.
Jennifer Mikel (23:54) I am looking at seeing if there’s other options that we have available where we can get like a red receipt and a notification when they open it as well to kind of do the same thing that DocuSign did since that functionality was taken away from us. So I am exploring another way to send peer references to be able to track this better like as a whole.
Abby Gonzalez (24:20) Okay. Yeah, because I think that that’s been one of the biggest issues is that, you know, we had that peer reference in the past that say they’d never received the query. And then now we’re having this issue where the peer is unable to access the document.
Jennifer Mikel (24:41) So, yeah. So like I said, I’m.
Jillan Mayfield (24:44) sorry, quick question. I’m sorry, Jen. So if, like if a peer, so if they, if like Daniel sent it out, right? And it came from whatever email address, and the peer was able to respond to whatever email address he sent it from. Because when she sent us where she responded to it was, wherever she received it from. So, is Daniel, like not able to receive, you know, any reciprocation from someone from where he sent it out from that email. I think that’s where she responded to, wherever she got the request from.
Jennifer Mikel (25:16) So, I’d have to see at the top if it says like no reply at the top from when Adobe sends it versus her actually clicking the email address and sending it.
Jillan Mayfield (25:29) Okay. So there’s so they can’t just like reply, they would have to click on the actual email address.
Jennifer Mikel (25:35) Yeah, I’m pretty sure that it comes from like a no reply for Adobe.
Jillan Mayfield (25:40) Okay. So when they’re sending the references out on your end, if a reference needs to follow up, if they hit reply, then it’ll just, it’s to the abyss somewhere.
Jennifer Mikel (25:49) Yeah. So I can test it and send you one Julian and see if you reply, like if you look at the address and see where it sends to. And then that way we can kind of.
Abby Gonzalez (25:57) Yeah, because.
Jennifer Mikel (25:58) Like honestly, I’m not sure. Yeah.
Jillan Mayfield (26:01) No, that’d be cool. Just so we can see like what they’re seeing on the back end so that, you know, if they have questions, we can just answer them pretty quickly and like you need to click on this or apply to that just so we can know, you know, have some type of idea of what they’re seeing or what they’re replying to, right?
Abby Gonzalez (26:18) Because also the one that he sent me that’s also why I was questioning if the one that I received is exact the way that it looks out, it looks when he sends it because it does have his email address there. If you have questions, contact Daniel friend.
Jennifer Mikel (26:40) Let me.
Abby Gonzalez (26:40) See what was it? What was the email? I know that his email is in what I received, if it’s the same thing that the providers received, then his email address was listed?
Jennifer Mikel (27:00) That is the same because we sent you a test.
Abby Gonzalez (27:07) Okay. Yeah. So I don’t know if there’s… some kind of blocker on the back or if it maybe went to his junk folder that he wouldn’t have received it, but I think that just, we just want to make sure that we don’t have this issue moving forward. Like how can we avoid the timeline where, you know, we’ve gone four weeks and none of dr childress’s peers have replied. So.
Jennifer Mikel (27:37) That’s why I said I wanted to try to find a better platform or a better way to send these. So we can see when they’re open and that kind of thing. And I should be able to have an update for you on that tomorrow because I just started exploring that today.
Abby Gonzalez (27:54) Okay. Yeah. Let’s revisit when we meet next week on your findings because I think that the most important part here is just making sure that, you know, if we send the peer reference out one that they’re receiving them, and two that they’re able to open it. No, I agree if we need to, you know, if we need to send it on our end because we have Adobe acrobat… sign, I think is what it’s called, then that’s where we can communicate, right? We can bring it to the table and say these peers have not responded in three weeks. Let me reach out. And sometimes it can be as simple as, you know, what? I’ve been so busy. I haven’t even had time to open that email, but we have that open communication to say, yes, this peer hasn’t replied, but they’re going to get back to it or can you try this other alternative email for that provider?
Jennifer Mikel (28:50) No, I understand.
Abby Gonzalez (28:54) But acrobat is one, Jen, if you want to look into, that one gives receipts and has the… like the certification at the top that there was a real email thread. It went to the providers, whether they opened it five times and then finally signed it. It stayed stamped.
Jennifer Mikel (29:15) Okay, great. I’ll.
Jillan Mayfield (29:16) look at that… real.
Collette Waddell (29:19) Quick. I just wanted to be mindful of time. I know we were only able to squeeze in 30 minutes onto the calendar today. Abby. Was that, did we have anything else that we weren’t able to cover on the call?
Abby Gonzalez (29:37) Dr. Nass, I think one of the biggest things also is I know that as we started to take some of this back and complete the profile, I noted that stony brook hospital was a hospital verification that was not verified for his file. And so I’m unable to see even though like say I made an update earlier this week, I’m unable to see what was updated. So, like if we say stony brook hospital was not in his profile when we assigned it, Jen moved it to committee. And then we went and we added it, not saying that that’s the case that happened here. But that is something that I was wondering because I did see that it is a appointment in his file, but I did not find the verification for it.
Jennifer Mikel (30:33) Okay. I’m looking, yeah.
Collette Waddell (30:36) I was wondering, would you be okay? And, I know I have to hop to another call right now, but would you be okay if we just did a little bit more investigating in terms of dr Nath’s file and maybe just sent a follow up email regarding like what we discovered?
Abby Gonzalez (30:53) Okay. Is that okay? Okay?
Collette Waddell (30:58) And then we can reconnect on our Tuesday call and the conflict… that Jen has is recurring it’s weekly too for our standing meetings. I don’t know if we want to also maybe explore if there’s another time block that might work better with scheduling to meet regularly. So at least we can have Jen for a couple of minutes just to, you know, to highlight the appointment piece of… the day to day things that we’re working through. And so we could just maybe take that back internally, look at calendars. If there’s another time that we might want to consider moving our call time to. But for now, we can keep it for just this coming Tuesday, just as is unless we correspond back and forth before then, but.
Abby Gonzalez (31:51) Coming up Tuesday, Jen will not be available, correct? Correct? Okay. So we can we’ll take this internally and see what other times work for Jillian, Adrienne, and myself. And then Jen, if you want to send us your availability, so we can see if we are able to work around that, so.
Jennifer Mikel (32:09) Thursdays, if Thursdays work for you, Thursdays are the easiest day for me. Tuesdays are my busiest, so.
Adriana Hernandez (32:16) If that.
Collette Waddell (32:18) Helps. So, yeah, maybe after this call, just take a peek internally at calendars and maybe if you have any options for a Thursday call, we could look at everybody’s calendars and just move the cadence. Okay.
Abby Gonzalez (32:36) We’ll look at this. Okay. Thank.
Collette Waddell (32:38) You and just, yeah, just send us an email, but we’ll take a look at dr nass’ file and just get a follow up with the findings from that missing hospital and.
Adriana Hernandez (32:48) Colette on Thursdays. If you can take a look and see if you guys have the availability Central Standard Time, 1,112 or two.
Collette Waddell (32:59) Okay. I will. Sorry.
Abby Gonzalez (33:04) I meant to stop sharing.
Collette Waddell (33:07) You don’t have to give us a name for right now. Yeah. So let me, yeah. And so repeat those times for me just one more time. So I’ll just note them down.
Adriana Hernandez (33:18) 1,112 and two Central Standard Time 11.
Collette Waddell (33:22) 12 and two. Perfect. We’ll take a look and send something over. Thank you. All right.
Jennifer Mikel (33:29) Bye, you guys. Bye.
Collette Waddell (33:31) I appreciate it. Thanks everybody. Bye. Thank you.