Transcript
Naomi Denson (00:00) hey me. Hey, Naomi. Good afternoon. Bye.
Sharonda Caceres (00:03) Bye guys.
Naomi Denson (00:06) Welcome back, Amy.
Sharonda Caceres (00:08) Thank you.
Naomi Denson (00:11) All right, Abby, Lisa, Sharonda.
Naomi Denson (00:27) Hello? Hi.
Leisa Sommer (00:28) How are you? Good.
Naomi Denson (00:30) How are you? Hi, everyone. Hi… why won’t this? Let me go. All right. Let’s see anybody else that we’re waiting on? Haley Taylor?
Leisa Sommer (00:54) They should be joining shortly. Okay. Let’s see.
Naomi Denson (01:04) Sharonda… the healing hearts, I just got confirmation that the payer mapping is ready for your review. So if you will review, the payer mappings there, confirm those. Let us know if you have any questions, we can get the provider enrollments for healing hearts that were shared over imported. I just dropped the link to this in the chat on the zoom.
Sharonda Caceres (01:36) That’s awesome. Thank you, Naomi.
Naomi Denson (01:39) Absolutely. Hi, Harrison.
Abby Meagher (01:43) Hello, everybody. All right.
Naomi Denson (01:47) So let’s see. This was, as of Friday, this was when I put this agenda together. And then I had to step away, but, so… there were still a handful of providers who had not been invited, and I didn’t know if that was something you wanted us to go ahead and bulk, send those out or?
Sharonda Caceres (02:14) So, yeah. So we’re gonna, we’re doing this very slowly, partly because some of those Nevada providers are not joining right away and they don’t need any enrollments right now. So, yeah, we’re gonna handle that on our side. Okay?
Naomi Denson (02:30) Perfect. All right. So, I’ll let you guys handle that.
Naomi Denson (02:34) Just have an overview from Friday of the payr enrollment statuses that you guys have submitted requests for? As of Friday, there were 23 open tasks I’m seeing 16 now. So, you guys are working through those, any questions about any of the tasks on the enrollment?
Sharonda Caceres (02:52) I don’t have any, Abby, Lisa, do you guys have any?
Abby Meagher (03:00) Not that I can point out right now. I feel like we’ve been working on the ones that we’ve been kind of stuck on. So, I’m okay, right now.
Sharonda Caceres (03:07) Okay. I.
Leisa Sommer (03:08) did have one question?
Naomi Denson (03:11) Okay.
Leisa Sommer (03:13) When we, can we start requesting and Sharonda, maybe this is a question for you. So I apologize, can we start requesting group enrollment with ipns or individual like tricare or?
Sharonda Caceres (03:32) United. So here, so Lisa, we can, okay, so let me back up a little bit, right? So, let’s just take like Illinois right now, advocate, right?
Naomi Denson (03:42) Okay.
Sharonda Caceres (03:43) Advocate needs way too much hand holding right now. Got it for me to feel comfortable to put them through, right? Okay. Right? So, I think that we need to be mindful of them like, I know that we need to do the blue cross blue shield enrollment, which we have that already set up there to do and all of that. But, and tricare, we can do that on our own. That’s not an issue because they don’t take care of that for us, but just the whole process itself because we still don’t have any of our providers in network at this time, right? I don’t I feel like that would be essentially dropping the ball on our end. Do you get what I’m saying? But for the other, but for the other ipns and ipas, I believe we’ve already built those folks in, right? Naomi because we sent over that. What do you call it? The… my goodness, I forget. I don’t know if you called it attestation, what was that called? That spreadsheet that Lisa and Abby worked on?
Naomi Denson (04:43) The appointment entities?
Sharonda Caceres (04:45) Yeah, the appointment entities, right? Yeah.
Naomi Denson (04:47) So, the appointment entities was for the privileging piece in your contract, the hospital appointment?
Leisa Sommer (04:55) Oh, just for the hospital?
Sharonda Caceres (04:56) Oh, it’s just for that.
Naomi Denson (04:57) It’s for, yeah, that’s for the hospital appointments.
Leisa Sommer (05:00) Okay. Now.
Sharonda Caceres (05:01) Let me ask you this when, okay? Because you all work with the ipas, right? So, some of our ipas are already in your system and you remember when we had to submit? Like who our point of contact were at our ipas and all of that. And we submitted that, I don’t know like a month or maybe a month and two months ago?
Naomi Denson (05:21) This one is.
Sharonda Caceres (05:22) It, this one, yes. Does this permit us to start sending those requests through for our ipas? I?
Naomi Denson (05:33) Will defer to, Jacqueline, have you had a chance to review all of these? And there were some, I know you had said that you had some other processes and things Sharonda that you were working on getting together? I just didn’t know if this that.
Sharonda Caceres (05:49) Was for Illinois, yeah, Illinois, we’re going to have to hold on them because it’s too chaotic.
Naomi Denson (05:54) Okay. Because I know we’ve already submitted some for advocate… right?
Sharonda Caceres (06:00) Which is the one that we had to cancel, right? Because that was like early on, I think we were testing or something out at that time, but essentially… moving forward with the exception of advocate, right? With the exception of that, could we start to put in requests for those?
Sharonda Caceres (06:22) So, like for our wellstar and the rest of them, yeah.
Naomi Denson (06:29) I’m going to Jacqueline, if you had a chance to review this and build any project plans needed in reference to like their contacts and things that we should be using on here.
Jacqueline Jones (06:38) I will need to review it and.
Leisa Sommer (06:40) kind.
Sharonda Caceres (06:41) of.
Jacqueline Jones (06:42) go through and see if there’s anything independent we need to go through.
Sharonda Caceres (06:46) OK. I appreciate that, Jacqueline. Thank you. Is there, is it possible to, for rather for the review to happen this week? Maybe for the most part, all of our applications have been submitted, but we’re just, you know, as new providers come on, you know, from day to day just want to see if we can have something built out for them. So that way when we’re ready to go, it’s ready to go.
Jacqueline Jones (07:10) Most definitely, yes.
Sharonda Caceres (07:11) Thank you, Jacqueline. Appreciate that. Sure. Awesome.
Naomi Denson (07:18) Yes, and then just wanted to touch on the appointments. So the hospital applications for the provider privileges, as we talked about before this was, you’re contracted for 10. Currently. If the need does come up, I just wanted to give you a quick overview of what this looks like. So the privileging tab is where provider appointments for requests for hospital applications would be made here and it would be just similar to the payer platform, but you’re going to be requesting an initial appointment, you would select your provider, and then we have the entities that you provided to us loaded here. So you would select which entity. This does look like ipas. Now that I look at the ipas and not the hospitals. How did that wait entities? Oh, and then child entities… for the hospitals. Is that, is that correct? So the ipas, you get your provider’s privileges at the ipas? Yes. Okay. That’s okay. Yeah. So that’s where that, that’s where the lines… got crossed there when you mentioned that sheet earlier, but yes, this is related to applying for privileges versus applying for enrollment through the ipa. So is that still something that you’ve envisioned needing?
Sharonda Caceres (08:44) We, we more than likely will because I think we have to do that what every 90 days or so? So, 90 to 180 days or something like that or whatever. What have you, but let me ask you this. Speaking of, this section, is there a way that we can link our providers, to their respective hospitals? Like, so we could just have it on file. So, we know like,, dr Shan is with masonic that type of thing without having to put in a request.
Naomi Denson (09:13) So, you can put in existing appointments to say that the provider has an existing appointment at this entity with… masonic and all of these. So you can, yes, you can put in an existing appointment for the providers.
Sharonda Caceres (09:34) Oh, that’s awesome. Lisa. Yes, that’s going to be your task?
Naomi Denson (09:42) Because, you know.
Sharonda Caceres (09:43) Them all so well, huh?
Leisa Sommer (09:45) I’ve seen it coming.
Naomi Denson (09:46) Okay. And I want to make sure as we’re adding these existing appointments, we don’t want an automated request for reappointment that’s typically every two to three years, correct? For reprivileging or recredentialing at the hospital. Oh,
Sharonda Caceres (10:01) yes, you?
Naomi Denson (10:03) Do want that.
Sharonda Caceres (10:05) No, we don’t want it to be automatic.
Naomi Denson (10:07) Okay. Yeah.
Sharonda Caceres (10:08) We want to wait till like they send us something.
Jacqueline Jones (10:12) Okay.
Sharonda Caceres (10:14) At least for advocate because advocate can’t seem to get their stuff together. So.
Leisa Sommer (10:19) And Trinity through hvpa, they automatically start the recredentialing every so many years.
Sharonda Caceres (10:26) Oh, they do it. Okay. That’s nice.
Naomi Denson (10:30) Okay. Now, okay. I think I need a little bit more clarification. So, these are ipas, are you enrolling them with the ipas or are you filling out an actual hospital application to their mso for privileges to provide services in that hospital? Both. Yes. Okay. Just wanted to make sure. Okay. Yes, you can add those there and I can set all of the entities that we loaded for you to not automatically request three appointments when they expire, and then you guys would either maintain those directly in the platform or request them from us as they come up if needed now?
Leisa Sommer (11:10) The only one that doesn’t go through the group, the ipn ipa is in Michigan, the Michigan provider. So, hvpa is the group, the ipa, the ipn and Trinity is the hospital, and it’s two separate outreaches. It’s not through the group. Will that affect when I go to put that in?
Naomi Denson (11:36) There… say that one more time?
Leisa Sommer (11:40) So, for instance, advocate or wellstar, when we apply to the added provider, to their group, they start the hospital credentialing… but with,
Naomi Denson (11:54) hvpa?
Leisa Sommer (11:56) It is separate. The hospital is separate?
Naomi Denson (12:00) Okay. I get what you’re saying now. Yeah. So, if you’re just doing it through the enrollment process. So, which one did you say it was wellstar?
Leisa Sommer (12:13) No, hvpas and their hospital is separate. They don’t credential together.
Naomi Denson (12:23) They don’t credential. So, which one is it that you said? Does credential together?
Leisa Sommer (12:27) Oh, advocate does and wellstar?
Naomi Denson (12:33) So, it would just be an enrollment request in the platform and medallion versus two separate requests because it’s not, it’s the same process.
Leisa Sommer (12:43) For wellstar and advocate, right?
Naomi Denson (12:46) Now, do you need to track? I think I just need to understand, do you need to track these as separate appointments if they’re being managed through the enrollment through the payers tab? So you could see that they, you know, you have enrollments for… let’s see, I… guess we didn’t load any of those… okay?
Leisa Sommer (13:19) Sharonda, what do you think? I think it would be nice to see? But if it’s too cumbersome, or if?
Sharonda Caceres (13:26) What would be nice to see the?
Leisa Sommer (13:29) Enrollments for… advocate and wellstar, and Naomi, correct me if I’m wrong. You’re saying when we initiate it, we would see that in this lineup here.
Naomi Denson (13:42) Yeah. So if you, it depends on how you’re submitting it. So, typically, what I see with ipas is that they’re submitted as an enrollment request through the payers tab. So with these payer processes, you would submit an enrollment request for the provider at advocate, right?
Sharonda Caceres (13:59) That’s correct that’s what we.
Naomi Denson (14:01) would.
Sharonda Caceres (14:01) do, right?
Naomi Denson (14:02) So, you can, so… I didn’t see where we imported any of the existing enrollments for those ipas from the data that you provided us. So if you want them in here to show as a payer, you would add it as an existing enrollment.
Sharonda Caceres (14:22) Leisa, I can show you that. Okay. Yeah, I can show you that part. Yeah, because there’s not going to be any existing for zp central. Okay? Because we’re going through it right now. You know what I mean?
Naomi Denson (14:36) Right. I just want to make sure that we’re not, we’re adding them to the correct place versus, you know, privileges versus ipa for billing.
Sharonda Caceres (14:45) No, I understand it. I can work.
Naomi Denson (14:49) With Leisa. Okay. I just wanted to make sure because I haven’t seen that separated like that before. Yeah, no worries. All right. So, yeah, you can add the existing enrollments directly through the privileging and then our team will pick those up if you need every appointment or a new appointment at any entity, we would work with you there to submit the applications and all of the supporting documentation to the hospital follow through until we receive that approval. And then we would load those as existing appointments once they’re approved for new providers.
Leisa Sommer (15:31) Okay. Thank you. And.
Naomi Denson (15:33) Sharonda and Harrison did just want to check in one more time with you guys on the API build for future import needs?
Sharonda Caceres (15:40) Oh, yes. We.
Naomi Denson (15:42) Have had further discussions around that. Do you plan to try to transition out of implementation on Friday pending, you know, Jacqueline’s review of the payr process, scoping and making sure we’re set up there.
Sharonda Caceres (15:55) I think we, I think we are in a position to Harrison, do you have anything?
HarrisonLamons (16:03) Sorry, I was muted on that particular topic. Let me follow up directly with our internal team, Sharonda’s like Jean and,
Sharonda Caceres (16:11) okay.
Naomi Denson (16:11) Just.
HarrisonLamons (16:12) on that thread. Yeah, I think it just, there’s definitely work going on Naomi, but let me follow up internally.
Naomi Denson (16:19) Okay. Sort of make sure that it was still on, your radar, and then we will still plan to move forward and transition out of implementation on Friday.
Sharonda Caceres (16:28) All right. It’s.
Naomi Denson (16:29) exciting. Yay. And if you guys have any other questions or anything else throughout the week, let me know. And then I’ll connect with Jacqueline and we’ll review these payr processes and reach out with any questions.
Sharonda Caceres (16:41) All right. I appreciate that.
Naomi Denson (16:43) Absolutely. I hope you guys have a great rest of your week and I’ll see you on Friday. All right. Bye.