Transcript
Nicolle Hepp (00:00) hi, Lisa. Good.
Lisa Lasick (00:01) Morning, Nicole. I apologize for not having my camera on but I literally just jumped out of the shower and I am not prepared to be on camera this morning. I was up last night with emails and a bunch of projects. So I have a late start happening this morning.
Nicolle Hepp (00:17) Yeah, no, I hear you. It’s a Friday so we can be casual Friday camera’s off here. No worries at all that’s.
Lisa Lasick (00:23) good.
Nicolle Hepp (00:24) Yeah. Well, nice to meet you. I’m Nicole malkery, I’m on the partnerships team here at medallion located in Dallas, Texas. And I believe you actually have spoken with medallion in the past but it’s been a few years. Does that ring a bell?
Lisa Lasick (00:41) Me personally or the company?
Nicolle Hepp (00:45) I saw it was a call with you and Keith, but this was back in 20 24. So no worries at all if it’s not ringing a bell. Yeah, yeah, no worries. But really the goal of today’s call is to just understand where you guys have progressed over the past few years.
Nicolle Hepp (01:02) I’d love to hear about your credentialing process. And then I’ll share a bit more about medallion, kept it at 15 minutes here today, so it’ll be quick short brief, really just want to determine if you’d be interested in a 30 minute deeper dive session at a later date where we can go over a full introduction of medallion. But no worries if you guys are all set as well.
Lisa Lasick (01:23) Well, I think what I’ve been researching or what I was looking for assistance with, which is how I ended up. I think Keith had your contact information and I had already took a look at your website, but the one thing I’m looking for is assisted in delegating credentialing like sops. I saw that you guys had just giving us the documentation and the guidelines that we need to follow to become delegated. Because currently, we’re using Healthstream and I’m not sure if you have that in your notes from talking to us prior, but, and I’m very happy with the software. I don’t have any issues with it. The support team is excellent there. So I’m really not looking to change into another platform, but I did notice that you do offer delegated credentialing support and I’m looking more for the documentation, sops, making sure that we’re compliant with ncqa because we’re having issues with optum. So that is pretty much what I’m looking for.
Nicolle Hepp (02:32) Okay. Yeah, absolutely. Makes sense. And yes, I did have in my notes that you guys were using Healthstream. I also have and, you know, tell me if this has changed or if there’s been any growth, but I believe at the time you had a three person team and about 700 providers. Is that volume still accurate today?
Lisa Lasick (02:55) Yep. It’s still accurate, pretty accurate today. Although we have gained more facilities we have since that time, I think we’ve had two other facilities join. But the thing the rotation with the number of providers is just they come in and they come out. So if they didn’t leave us, we would have probably thousands of providers, but yeah, we’re about 700 right now. My team is a four and I’m getting a fifth person. So we are growing in ftes. But that’s really the only change.
Nicolle Hepp (03:31) Gotcha. Great. And so with the provider count, is there high turnover? Is that the challenge you guys are experiencing?
Lisa Lasick (03:41) We do have high turnover mostly with the clinical staff and not so much the medical staff more so with the clinical staff, nursing staff, things like that. But.
Nicolle Hepp (03:56) Yep. Absolutely. And then you guys are using credentialstream. I’m assuming that’s for like credentialing primary source verifications, things like that, correct?
Lisa Lasick (04:09) Well, we use it for payer enrollment as well. Okay. So three of my, so the reps that I currently have on staff. So I have four in total right now and I just hired somebody yesterday, so it’ll be a total of five. But currently, I have three staff members that are working on payer enrollment, and only one of the staff members that works on dedicated credentialing, because credentialstream is very simple for credentialing. It’s just the data entry pieces and keeping up with the monitoring. Other than that, it’s fairly simple on the credentialing side where we struggle is on the payer enrollment side because we’re not delegated. So we’re having to do all the applications. So what I see happening is if I start exploring the delegated credentialing, it’s going to be more heavier on the credentialing side and less heavy on application side. So it’s kind of like you’re moving things from one hand to another hand is the way I feel about it, right? Yeah.
Nicolle Hepp (05:12) Absolutely. Yeah. I mean delegation is definitely something that medallion does help stand up delegated agreements with payers and we do the direct enrollments as well. So we can really help you guys on that PE side if that’s where you would like to gauge the conversation. And I know you mentioned optum, which is funny because optum is actually one of our customers. So that could certainly be a point where we start and really dive in with you guys and see if there’s any challenges there that we could quickly course correct for you. What exactly were the challenges that you were experiencing with optum?
Lisa Lasick (05:45) Well, the challenge of credentialing for us is that because they follow ncqa guidelines, they’re looking at the payer guidelines. So their payer guidelines in ncqa are different than what a provider’s guidelines are for ncqa. And so when they gave us their credentialing requirements to be delegated, it was like 300. It was a spreadsheet with like 300 questions or tasks or whatever. And I’m like, are you out of your mind? Yeah, if delegation requires this much work for us to become delegated, then no. But unfortunately, that means we can no longer have any group practices in addition to our, they’re giving us our facility contracts, but they’re no longer giving us the physician group part. So that’s been a little bit of a challenge because that’s revenue that we’re missing there. But again, for the amount of work that they want us to do for a delegation, it amazes me because I don’t see the same amount of effort coming out of what they’re asking us to do. In other words, the payer enrollment applications, the licensure that we’re giving them all the documentation that they require. What are you actually doing with that primary source verification? That’d be number one, right? So, I’m not sure how much of a deep dive on their side, they’re actually doing when it comes to credentialing a provider, but you’re asking us to jump through hoops and go through a 300 question checklist for us to become delegated. I don’t know. I don’t get it, right.
Nicolle Hepp (07:23) Yeah, no delegation definitely is there’s a lot of requirements and medallion is actually an ncqa certified cvo. So we can help you guys stand up those delegated agreements with payers. Because we do have clients like optum. So, I mean beyond optum, we also have relationships with virtually all major payers in the country because we have done this at scale for about 400 clients at this point. So we know what they’re looking for, right? We have a rolodex of delegation already built out at medallion. So depending on which payers you would want to get delegated with, we can certainly help stand up those agreements. And we already know what they’re looking for. So certainly that’s a big portion of where medallion can help our partners. Yeah. And.
Lisa Lasick (08:13) I think too that the biggest struggle for me is like, for example, I’ll give you a, for example, I know we’re short on time, but so like the, for example for us is like they want us to have a monthly credentialing meeting, which I do have a standing monthly quote unquote credentialing meeting, but we don’t discuss providers that are coming aboard. And the reason why we don’t do that in that meeting is because we do everything virtually, right? So through onboarding, recruiting, all those steps that we do there, the background screenings, all of that, and the credentialing component as well. If we’re coming up with any kind of problems with a potential employee or a staff member, those issues are addressed at that time. They’re not waiting for a monthly credentialing meeting. We don’t have time to wait to say, I have a standing meeting on, you know, every third Monday to discuss potential employees coming aboard. We don’t have that many employees coming aboard. So if we get maybe two people for a month, we’re not going to hold up their onboarding to get them to the third week of the month in order to approve them for credentialing. Does that make sense?
Nicolle Hepp (09:28) Right. Yeah, we’re approving.
Lisa Lasick (09:30) them upon hire meaning that we’re running all the license checks. We have to do that anyway for joint commission. So we run and state requirements, we run all of our license checks, sams, oig, everything prior to hire, if anything shows up on anything mpdb, all of that, if anything shows up, we’re addressing it with senior executive leadership teams through email with documentation and supporting documentation to approve the hire. So from there, we’re covered as far as I’m concerned. So the requirement of having a monthly credentialing meeting makes no sense for us. I mean we can do it to be in the motions, but I don’t know, basically I’m going to say this person got hired, this one was approved to hire. This one was approved to hire. That’s how that meeting is going to go.
Nicolle Hepp (10:18) So, yeah. So because I guess because of these timelines, is delegation something you want or is this maybe… not the best fit for?
Lisa Lasick (10:29) You? Yeah, honestly, I mean we’ve passed every state audit we’ve passed every joint commission audit. The credentialing sign has been pristine. We have had no issues. So the biggest problem that we barrier that we have is by not being delegated, right? Not being delegated, means that we have to fill out the payer applications, right? Correct? So that is fte work that could be better utilized, doing something else and less ftes that we need if we were to become more delegated. So that part of it is the only reason why, because then we’re doing rostering instead of doing, you know, full applications which take time. So just doing rostering, then it’s like pretty much a quick done deal situation with the payer enrollment. But so that’s my problem. I mean, so do I bite the bullet and have a credentialing meeting? Or I don’t know. And Lisa.
Nicolle Hepp (11:31) This could be something that we discuss at a later time. I know we have only a few minutes left, but like I mentioned, medallion definitely does help stand up delegated agreements with many payers. So we can walk you through what that looks like at a later date as well as the platform. So, in our platform, we have these payer requirements built out. We have, you know, if you had a committee for delegation, they can log into the platform and just simply approve right there in the user face. So it’s super user friendly. And what that does? I mean with delegation and medallion involved, we can usually get that turnaround time in just under a few days. So, those issues with timelines that you’re talking about with direct enrollments. We always do push if the organization is at a good size to get delegated agreements in place just because it does speed up the process significantly. So, does this still interest you? Would you want to get on a 30 minute deeper dive where we can really show you like more what the platform looks like, talk more about our payer enrollment and delegated agreement offering at a later date, maybe next week?
Lisa Lasick (12:41) Yeah. Let me look at my calendar really quickly and see what I’ve got.
Nicolle Hepp (12:44) Great. That’ll be, yeah, a 30 minute meeting. So, let’s look at March 20 third week.
Lisa Lasick (12:54) Usually, the best days for me are going to be either on a Monday or a, Wednesday. I’m clear next week. So… okay, let’s.
Nicolle Hepp (13:05) see… looks like unfortunately, the colleague that I would bring in to the call, he’s out Wednesday through Friday. You happen to have Monday or Tuesday available at all?
Lisa Lasick (13:25) Let’s see, Tuesday is a difficult day for me because I have a lot of meetings on Tuesday. So, I would say Monday is probably better and let’s see, want to try 10 a M.
Nicolle Hepp (13:42) Eastern and you are Eastern Time? Is that correct? I’m.
Lisa Lasick (13:45) eastern? Yeah. So it’d be nine o clock your time, right? Yep.
Nicolle Hepp (13:48) Let’s do that nine a. M central 10 a M, eastern Monday, the 20 third? Yes, sound good?
Lisa Lasick (13:55) Yep. Sounds good.
Nicolle Hepp (13:57) Perfect. I’m sending that over right now. And I’ll let my colleague know I’ll be on the call, but I’ll let him know exactly what you’re interested in. Just just so you know, medallion does offer credentialing as well. But, if this is more of a pay or enrollment conversation, we can certainly stick, to that information as well as, the delegated agreements?
Lisa Lasick (14:17) Is there anything else you’d like to touch on? Yeah, I’m sure that, the platform that you’re using for credentialing is probably very similar to what credentialstream does. So, I’m not, I mean, if we need to do a changeover, I’m open to that, but we’d have to look at the cost for implementation and the cost per provider and stuff like that. But I don’t know. We’ll we’ll see, right?
Nicolle Hepp (14:43) Of course. Yeah. And, and we do that, at a later date, we can, how it works is we’ll get some of your inputs, you know, volume turnaround times, and then we’ll do an analysis of medallions and you’ll be able to see if there’s a true Roi there or not, which would make sense to continue the conversation or not. So certainly something we think about.
Lisa Lasick (15:04) Alrighty. Thank you so much, Nicole. Thanks.
Nicolle Hepp (15:06) Lisa and I will see you Monday. Have a great weekend. You too. Bye bye.