Transcript
Kyle Bettencourt (00:00) I’m letting everyone in. Cool.
Kyle Bettencourt (00:17) Hey, good morning. Good morning, team. Good morning. How’s it going? Jeremy? Eric, nice to meet you. Looks like Bobby’s still connecting there?
Eric Svonavec (00:30) Yeah. It is bright and early for Bobby.
Kyle Bettencourt (00:34) It’s Bobby west coast?
Eric Svonavec (00:36) Even wester, she’s in Hawaii.
Kyle Bettencourt (00:38) Oh, wow. Gosh. What is it like four in the morning out there? Yeah.
Eric Svonavec (00:42) Exactly. I told her. I was like Bobby, you don’t have to join.
Kyle Bettencourt (00:48) We greatly appreciate the presence there that’s commitment.
Eric Svonavec (00:53) Yeah. No doubt. Yeah, she’s actually. So she works for one of our bigger clients, Maui medical group. She runs the billing over there and I had reached out to our staff. I’m like, hey, who’s the provider credentialing expert on our team? And everybody kind of just shrugged and looked around at each other like, I don’t know. So I’m like, all right, well, a client of ours probably does a lot more provider credentialing than we have anything to do. So, I hit her up to see if she’d be able to join. Yeah. Oh.
Kyle Bettencourt (01:31) Perfect. Is Bobby, is she with Maui medical group? Yes. Okay. Yeah, I was checking that story out on your guys’ website yesterday, just kind of getting up to speed on the conversation here. Yeah.
Eric Svonavec (01:46) And it’s actually kind of unique too because we do, she does work for us part time doing QA. Okay. She’s in on a lot of our product meetings. So it’s a fun little situation. Very cool. Yeah.
Kyle Bettencourt (01:58) I mean, that speaks highly to you guys that, you know, customers are willing to jump on, yeah, and make sure that you guys are getting support, no doubt. Well, cool. I’m going to leave my camera off. I’ve been having some internet issues here this morning. So, yeah.
Eric Svonavec (02:16) That’s okay. I’m not going to put my camera on. I’m not dressed enough well enough for this meeting.
Kyle Bettencourt (02:21) Right now… that’s fair, well, cool. So I guess just we quickly introduced the medallion side here. So my name is Kyle bettencourt, I’m on the sales and partnerships team. So I’ll kind of be your main point of contact, from our side. From this call moving forward, I work pretty closely with Kirsten, kind of covering similar size provider groups. And then Noah who just joined the call is my solution consultant. So he’ll bring me the technical knowledge of credentialing and enrollment here for the call today. I know you guys had a chance to stop by our booth at himss, and then I think Kirsten got ahold of you Eric, and you wanted to set some time to kind of learn a little bit more about medallions.
Kyle Bettencourt (03:06) So we’d love to just maybe hear a little bit about what you guys are looking to do a little bit about open practice and we can kind of go from there.
Eric Svonavec (03:17) Yeah, sounds good. So… I lead the product and development teams at open practice. So, a lot of my time is spent talking with other product people from a lot of our partners. So we do practice management and billing software and that’s all we do. So, we’re the back office of your ambulatory clinics and we don’t do ehr. So we integrate with a lot of ehrs. We do a lot of white labeling, right? People don’t even realize they’re using us, they think they’re using an all in one solution with an ehr, but really, it’s 50 50. And the question I get from a lot of my counterparts is, well, what is your guys answer for credentialing? And up until recently, I haven’t really heard that question and we have like a very generic credentialing like functionality in openpm, where basically you associate a provider with an insurance company with a date, right? So this provider with this insurance is credentialed as of this date. And then we have some validations to say, you know, if it’s a date of service prior to that date, it’s like, oh, they’re not credentialed. So it’s, very basic and it’s all manually managed now. I, like I said, like I reached out and it’s like there isn’t the expertise I would say on our side for really what it is we think we should be adding. I don’t think we really have the context of how much work it is for our clients to do whatever it is they’re doing. But the people that actually talk to the providers are the ones coming to me saying, hey, we need a better answer because this is a pain point. So, I was hoping to get sort of like an education from you guys on why we would need an integration with a company like medallion and ultimately, how that fits into our product.
Kyle Bettencourt (05:40) Excellent. Well, that’s that sounds good. Yeah. And I can definitely kind of jump in and give you guys the high level of medallion and sort of, what we offer. I guess just out of curiosity, like how often are you guys getting these types of requests now?
Eric Svonavec (05:55) Yeah. I mean, it’s you know, I have like monthly calls with different people and it’s a line item, right? That gets brought up. And, you know, I’ve got it on my whiteboard of all the integrations we’re doing. I had credentialing with a big question mark next to it, and I’ve since replaced that question mark with your name. But yeah, I mean, it’s we’re not getting our doors beat down, right? I think up to this point like there’s always been another priority but we saw you guys at the show. I’m like I get asked this question. So, I, you know, it was definitely worth a chat and worth an education. And, you know, I think, you know, if there’s something that is viable here and if we marketed it, I bet people would climb onto it because it’s not just something they think that they can ask for, but it’s like, whoa, I didn’t realize that open could solve that problem for me.
Kyle Bettencourt (06:54) Right. Yep. Well, cool. That makes sense. So, I’ll just kind of start with like our overview slide of sort of the full offering of what medallion has to offer. Did you get, I mean, did anybody show you like a demo or no? I guess, what do you know about medallion? Nothing? It’s called just sort of like first intro for you guys?
Eric Svonavec (07:14) Correct. Okay.
Kyle Bettencourt (07:15) Excellent. So, yeah, I think like the best way to think of medallion and what we offer, we’re an end to end platform for all phases of your provider data management, right? And so kind of phase one is we’re able to, collect your provider data and manage that in a centralized platform and give you visibility into their status, you know, across all of, their credentialing, their licensing, basically, any type of data that you need to understand about any of the providers that you have is gonna be living in medallion. And then because we can centralize all that data into one place, we then use automation and AI, to kind of expedite workflows around credentialing itself. And so… typically, you know, once providers are credentialed we’ll then help them, with payer enrollment, getting online with their billers. And then we can kind of help manage licensing and ongoing monitoring sort of after the fact to ensure that your providers are staying, you know, up to date if you will. If there’s any type of licensing or recredentialing that they need to do, you know, down the line, so that’s kind of a high level of sort of where medallion can offer. And so as far as like the credentialing piece, that you guys, are looking to fill, is it primarily kind of just like the onboarding and then verification, of those providers? Or is there like an aspect to like the payer enrollment piece as well that you guys are looking to automate for these folks?
Eric Svonavec (08:48) Yeah. I mean credentialing was definitely top of mind. Now when you talk about payer enrollments up… to this point, like when I hear that, I think, okay, well, we enroll for our eight 30 fives, and we do that through our clearing house so that, you know, Aetna will send the remittances to our clearing house and not their old clearing house. For example. Is that a different conversation than what you’re referring to… when you say enrollments? Yeah?
Noah Laack-Veeder (09:24) So, Eric, maybe I’ll just jump in really quick. So ultimately, just to kind of go back, I think what Kyle’s trying to understand is kind of the relationships of today. You said that this is something that’s been coming up more with credentialing. And I think what we’re trying to understand a little bit more is like how are you all currently involved with that process? Like are you currently involved or is this? Yeah. Okay. That’s what I figured. Okay. So with that being said, I think kind of what we’re when we have these types of conversations, Eric and I think you’re kind of at a really interesting point here where customers, are saying, hey, like what do you do for credentialing and you’re wondering, well, do we stand something up? Do we kind of recommend a partner and things like that? Ultimately? Like one of the first questions, I mean, again, it’s however, this is our first conversation, so it’s as much as comfortable as you are with it. Yeah. But how we typically think about it is like how this ends up? Like where we need to get to is, how is this going to help you as a business in a couple ways that we’ve had relationships with customers? Have been one, a really interesting use case is companies like yours have used like free credentialing as a way to get new customer acquisition. So that’s been a really interesting use case and it’s actually one of our largest customers who’s doing that. Other ones have been like, you know, like we actually have a small and mighty team that is doing some credentialing today. So that’s not that you, right? But I just want to educate you. They’ll be like, hey, can we just use medallion to do the credentialing for the customers? And how that usually works is they’re either, you know, charging a higher membership fee, a higher bills resolution rate, or like claims rate, or they’re marking up the service itself. But then there’s the ones they’re like, I’ve never done this before and I don’t really know how this fits. Have, you know, kind of thinking about, the business aspect of it? Like, how are you thinking about this partnership working out? Yeah?
Eric Svonavec (11:35) I mean, you know, ultimately, it’s whatever is going to be best for the customer. Our usually, when we pick companies like this and we integrate, we like to keep everything within our system. We don’t want people to have to sign into a clearinghouse to do that, to sign into medallion, to do that, to sign into something else to do that, right? We want everything to happen within open PM. So from like a partnership standpoint and a workflow standpoint for me, it’s do you guys have apis that we can hit to show credentialing statuses in our provider library? And if somebody needs credential there’s a button, they can click to do something, right? I’d like to keep them out of your portal if possible, but, yeah.
Noah Laack-Veeder (12:28) That, that makes sense. Yeah. And then, but go ahead there. I didn’t mean, I didn’t mean, and Jeremy, yeah.
Eric Svonavec (12:35) I was gonna say, Bobby, Jeremy, feel, yeah, pipe in.
Jeremy Munoz (12:38) I did. Yeah, I didn’t want to chime in real quick. So, are you guys familiar with the modio? Yes, we are. Okay. So I did help. A, so I don’t do credentialing. I did assist a client in researching companies out there that potentially can centralize their process. And really, the hope was to have automation and some integration. So when we landed with modio, I think the hope was at some point that they could integrate with caqh. We can send applications from modio to payers to do credential to credential with them. But that necessarily didn’t come to fruition. So for the most part, it just seemed like the client was still going to see a QH doing what they need to do there, and then coming back to modio, which I think more or less felt like it was document… storage at the end of the day. Yeah. And ideally, it would have been great to have some kind of bi directional integration, right? If there was an update in caqh, we can see that in modio, if we did do something, modio sent to caqh and, you know, reattest or something, right?
Noah Laack-Veeder (14:04) Sure. Yeah. And Jeremy just don’t understand this. So you’re saying one of the clients you were helping in your current customer of yours, they were using modio and you were trying to explore whether or not they could integrate, with you all. Is that what I’m hearing?
Jeremy Munoz (14:23) Well, not with our product. The client was just trying to see what was out there in terms of a credentialing platform. So I.
Eric Svonavec (14:34) ideally, it would have integrated with our.
Jeremy Munoz (14:36) product, ideally, right? Exactly. Sure. But yeah. So, right, ultimately, right? It just felt like at the end of the day, caqh is free, she might as well just stick with caqh. She gets alerts if something needs to be maintained. And then right, ultimately, with the payers, it still felt like she had to go to the portal to do credentialing because that they, she had to use their forms. The most modio could do was keep the forms up to date when there was a new form, but right, you know, there was really no integration with modio to send paperwork to a payer. Yeah.
Noah Laack-Veeder (15:20) And that’s typically what I hear, I think like it. And again kind of thinking about the landscape here depending on, you know, we have some organizations who are working with large provider groups, other ones that are working with small and ones that work with both. Modio is typically like, you know, one of the intro solutions that individuals will get when it comes to credentialing and it really doesn’t it doesn’t really automate much. It’s just more or less like a checklist or project management tool specific to credentialing like that’s kind of how I think about it, how medallion is a little bit different is, you know, we are, I just think of this as kind of like, if modio could automate everything and then also have specialists on their team, like that’s what medallion does. So what our partnership looks like with customers is, hey, you need this need like you have 10 new providers, they need to be enrolled or credentialed with 10 different payers in order for us to bill for services. So we gotta get them a network medallion. Hey, can you just do this work for us? They submit requests on our platform, we leverage a ton of automation and AI, and then we process all those automatically. And we surface the status and every, any other detail that you’re interested in and how we typically work with an RCM type company or billing company is, here’s, the like here’s the final result. So we have individuals in networks so we can start billing for that stuff. The other thing is some individuals are interested in investigating claims and aisles based on credentialing issues. Like we have the information to help with that kind of appeal process or that denial. So generally speaking, we are doing the credentialing for those individuals who kind of lack that strong knowledge of the payer space. Usually or then when it’s a large organization, it’s just so resource intensive, to do this work. That medallion just takes over that operation and then does the credentialing at a lower cost of the organization, but also with higher quality results. So ultimately like our value proposition is faster turnaround times, which means better revenue acceleration and then second reducing that operational cost which affects that bottom line as well. So does that kind of help you understand a little bit more of the difference between medallion, and modio? Yeah?
Jeremy Munoz (17:49) I probably would say most, maybe if not all clients that have a need for credentialing know how to credential. So they do it. They’re on their own interest. Don’t know, I don’t know. And Eric, correct me if I’m wrong, I haven’t heard of a client of wanting to know how to credential and getting into it most, yeah, have it, most have experience and need more capabilities exactly?
Eric Svonavec (18:18) Yeah.
Noah Laack-Veeder (18:19) Sure. Bobby.
Eric Svonavec (18:20) Bobby, what’s your experience with credentialing? How, how much work is it for you and your team? Yeah.
Bobbi Ranis (18:28) So, we credential on our end and I think it’s more, it’s repetitive, right? It’s every insurance company. Their forms are almost all the same. So like we create an internal document that we send to the providers that includes everything I need. They fill it out, right? We have a program that pretty much we just map all the forms. We enter the information and all my forms come out right with the information it needs. And I send it on. I think it’s so it’s that repetitiveness. But I guess my question is, how would you guys handle like certain payers, you have to go to their site or enroll in their system? Exactly credentialing? So, how would you guys get our information to do that part? Is one question. And then my second question would be, how are you maintaining? Or are you not? So you need Dea state narc, you know, mis their malpractice license and all of that. You guys maintain that and say, hey, look in four months, it’s going to come up. We’re going to send this all out to the payers again, if it’s uploaded one time, do you do it all? Or is that kind of something you still have to maintain? Yeah, those.
Noah Laack-Veeder (19:40) Are those are really important questions? Bobby and I’m like really glad that you asked those. I can definitely talk to those. But one thing kind of that I find successful is I can just show you in a demo. Now, the demo, I think I’d recommend, we probably schedule around 45 minutes to kind of go through that. So I can go through more or less the nooks and crannies of the platform, talk about those different automations.
Noah Laack-Veeder (20:03) Would you, would you all be open to that to just see the platform more detail to ask, answer more of those operational questions?
Bobbi Ranis (20:10) Yeah, yeah, definitely.
Eric Svonavec (20:12) I think we should schedule it probably couple hours earlier, even.
Bobbi Ranis (20:18) We can do a midnight call for.
Eric Svonavec (20:20) Bobby. Hey, she’d like that. That’d be a six PM her time? Yeah.
Noah Laack-Veeder (20:26) I was thinking, I was like, yeah, wow. Yeah, Bobby, are you usually an early riser? Like, is this just normal now for you?
Bobbi Ranis (20:33) Maybe not this early, but early.
Noah Laack-Veeder (20:36) Yeah. Well, yeah, I apologize, you’re like I got up so early not even gonna show me a demo today.
Noah Laack-Veeder (20:42) Well, at least Bobby, what I can tell you is like, and again, there’s a lot of proof in the pudding here and to show you this, but credentialing is all we do and we’re I call us a technology company with a healthcare wrapper. So we’ve got sizable investments, a very large engineering team who’s purely focused on those specific problems that you’re highlighting there, Bobby, like how do we integrate with payer portals? How do we navigate those different pathways? How do we figure out the best method of integrating with the payer? How do we automate payer, follow up, right? And all these other things that are really critical to making this workflow better? So that’s really what we’ve been trying to do for the last five years since our inception. And so thinking about medallion, those are the critical questions that we’re asking ourselves and how we do that. And there’s a variety of methods and how we do that, Bobby, but a lot of times it’s because we have last year, we processed around 100,000 payer enrollment applications with that. We have more or less an economy of scale. These payers know who we are. They sometimes they allow us to submit things and means that other organizations don’t have just because of our sheer volume. And then there’s other automations and other methods that we use to do those things. But ultimately, Bobby, I think that’s something I can show you, in the demo. But kind of, the ultimate question is like, you know, can you guys do these types of automations absolutely? But then it’s like, you know, why would we want to use a medallion? And ultimately, one thing that we can all work together on that we typically do with organizations, is it really only makes sense if we can do this faster than your current organization, we can work with our analytics team to tell you what our turnaround times for enrollment are and credentialing for these organizations?
Noah Laack-Veeder (22:34) But Bobby, just on your side roughly like, you know, maybe your problem payers or normal payers, like how long is it taking for these enrollments to get processed? Usually, I hear around 120 days, like how long does it take your organization, how?
Bobbi Ranis (22:50) Long does it take our organization to process the credentialing app? Or how long does it take to get a insurance number back? If?
Noah Laack-Veeder (22:58) You have, if you have both those top of mind, I’d love, but most of the time, the organizations they, they’re most interested in like how long it takes for us to get a number back or get that par, effective date back. But I’d just love to hear kind of what you’re currently seeing. Yeah.
Bobbi Ranis (23:12) So the par, effective date or numbers is totally dependent on the insurance company, right? I don’t know if you’re a cleaner fresh out of school provider or you’ll get those back quicker because there’s nothing to verify, right there’s just your college. There’s no previous employment or something like that. So those would get back a lot quicker. The previous employment ones. They, they take a little bit longer, but I would say turn around, we tell the provider from the data credentialing app is sent in about… we can start them. Most pro, most insurance companies will retro back even if it takes them longer. So we start them earlier because they’re retro back to your start date. You just don’t submit claims. So, I mean, there’s a process you know, in that part. But so I would say it’s not like tremendously long. I think we’ve got a good system. Like I said, it’s repetitive. So it just spits it out already done. We just attach our documents and send it on the way. So.
Noah Laack-Veeder (24:12) Bobby, what technology are you all using today? Or do you have a tool or are you just using spreadsheets or?
Bobbi Ranis (24:17) No, it’s a tool. It’s just like a program that we purchased a long time ago. I would have to go back and look at the name. I know the icon when I open it, but yeah, then.
Noah Laack-Veeder (24:28) Totally, totally fair. Yeah, it’s just a, so definitely think we can schedule a demo to kind of walk through that. But maybe just for the three of you, right? So we’ve got kind of like two different ideas here and I’m just kind of speaking openly since we have the whole group here. Like Bobby definitely want to talk about how we could potentially help your organization obviously. But then Jeremy and Eric, since you have other customers that are potentially interested in credentialing, I, I’m interested to see how we want to kind of move that conversation forward. But it seems like either way the next step is a demonstration. Does that sound about right? Yeah.
Bobbi Ranis (25:04) And I think for your demonstration now, I think you need to go… into detail. I don’t know if you can show us in an actual somebody system, but how do you integrate with open? Like can you demo how you integrate with somebody’s system? You know, a lot of people will demo. I can do this great. But when it actually works with another say practice management system, it doesn’t work like how you demoed it for sure. Yeah, I think that part, I mean, how do you do medicare?
Noah Laack-Veeder (25:32) Yeah, no, I think, that is a totally reasonable ask. What I can, what I can do is I can kind of in that first demo, I can kind of like kind of thinking about the different pathways integrations like a whole another thing to scope out.
Noah Laack-Veeder (25:49) And Eric and Jeremy, I know, I, Eric, I heard you laugh, right? Like I can definitely show you and I can commit to like what data is going to go back and forth. But to demo that there’s going to be a little bit more work to necessary to be able to show something like that. But ultimately, how we handle integrations is we just talk about what data points have to go back and forth between the systems at what cadence, and then how that looks and how that’s done is more or less going to be if we have an out of the box integration, I can show you what that looks like. But Eric and Jeremy, you know, we don’t have one with you all yet. So that’s something that we have to work through, but we do have an open bi directional API. We have integrations with tools like Salesforce, like we’ve integrated before. So Bobby, I can definitely talk to how it will conceptually work, but showing you exactly how it’s gonna look in the platform. I think that might be something later in the process if that works for you. Yeah.
Eric Svonavec (26:47) And, yeah, and I can, Bobby, I’ll be able to tell based on their API documentation, what they actually support. It’s like, okay, yeah, they have the API for that. We can put that in our product. Not a big deal.
Bobbi Ranis (27:00) Okay. As long as we get that part, cuz a lot of people will promise you the world and when it comes to it, it’s like that’s not what you said a.
Noah Laack-Veeder (27:07) 100 percent.
Bobbi Ranis (27:08) Yeah. So.
Noah Laack-Veeder (27:12) I know we’re coming up at time, so happy… to, should we just get something on the calendar now for this next conversation since we’re all here. Sure. Cool. Kyle, you want to look at calendars? Yeah. Also, I didn’t introduce myself. I mean, I’m no elite solution consultant. So my questions, you’re already seeing, I’m more technology focused. So, yeah, thanks for being a good audience today.
Eric Svonavec (27:42) No problem. Yeah, the enrollment question threw me because when I think of enrollments, I don’t think of anything to do with provider credentialing, I think of submission and eras and all that.
Noah Laack-Veeder (27:52) Exactly. Everybody says enrollment, everybody says credentialing, and then if you ask those two same people what they mean, it’s going to be different. So, yeah, totally makes sense. But Kyle, you want to just see some times it might work for folks?
Kyle Bettencourt (28:05) Yeah, I’m looking at next week so we could do… it’s. Going to be like noon central on Tuesday. Wednesday afternoon is a little bit crowded. Thursday is pretty open for us as well. Afternoon actually works too. So we got kind of spotty available on really kind of any day.
Eric Svonavec (28:32) How late are you comfortable joining our calls? Because I don’t know how much you’re okay with it interfering with your normal day to.
Bobbi Ranis (28:41) Day doesn’t matter whatever, okay?
Eric Svonavec (28:44) So, three o’clock eastern. So two o’clock central on Monday or Tuesday work for all of us?
Kyle Bettencourt (28:56) Okay.
Noah Laack-Veeder (28:59) Two o’clock central on Monday. I think that, yes, that probably is best for us. Noah, is that good for you? Yeah, that works.
Kyle Bettencourt (29:07) Okay.
Eric Svonavec (29:09) Perfect.
Kyle Bettencourt (29:11) Well, that sounds good. I’ll send an invite out to the group here and we’ll plan to connect for the demos on Monday afternoon and we’ll go from there. But I guess any last questions while we’re still on that we can?
Eric Svonavec (29:24) Help out with? Yeah, yeah, if you guys have, I don’t know if you have public facing API documentation that you could shoot our way in the meantime just so we can get some eyes on it. Yeah, other than that, I think we’ll just chat with you guys on Monday. Excellent. Well, that sounds good.
Kyle Bettencourt (29:43) Nice to meet everybody. And yeah, hope you all have a great weekend and look forward to reconnecting on Monday, yeah.
Eric Svonavec (29:48) You too. Appreciate it. Thank you.
Noah Laack-Veeder (29:49) Everybody. Thanks everyone.