Transcript
Karis Price (00:01) hi.
Nicolle Hepp (00:02) Is it Karis? Hi, nice to meet you. I’m Nicole.
Karis Price (00:07) Nice to meet you too.
Nicolle Hepp (00:08) How are you doing today?
Karis Price (00:10) I’m good. How are you?
Nicolle Hepp (00:11) I’m good. Thank you. Well, we can dive right into it. We have 15 minutes here today. I’m Nicole malgry, I’m on the partnerships development team here at medallion. So we typically hold these 15 minute syncs whenever we get any website inquiries, just to see exactly what kind of solution you guys are looking for. And then I’ll be able to share a bit more about medallion. But really end goal here is to determine, hey, are we a good fit and would you want to continue conversations or perhaps not? And that’s totally fine as well. Is that in line with what you were expecting for today?
Karis Price (00:45) Yes, it is.
Nicolle Hepp (00:46) Okay, great. Hi, I’m Nicole.
Karis Price (00:49) Hi, I’m josh. Nice to meet you. Nice to meet you. Thanks for taking the time to present this to us. Yeah, of course, for companies to help us out with credentialing, me and Karis are both new to this. So we’ve never used a platform that’ll help us out with credentialing right now.
Karis Price (01:06) We just use folders and spreadsheets and it’s not really working out the best for us. Yeah, we’re just kind of looking for more time efficient since we are growing. We have… yeah.
Nicolle Hepp (01:22) Absolutely. Yeah. Hear it often. You know, teams look to automate some processes. If you’re handling everything out of spreadsheets manually, it can certainly take up a lot of time in your day and become.
Karis Price (01:35) Pretty lengthy. It seems like we’re growing and getting new providers all the time. So it’s just one after another… yep.
Nicolle Hepp (01:44) Absolutely going off of that, I’m going to ask you guys just a few questions to get a sense of your volume. So about how many providers are you guys managing credentials for at the moment?
Karis Price (01:55) We have about 130 that are fully credentialed, and then we do have about 116 that are credentialed by proxy. That would be kind of more of a like we would just need a place to maybe store their profile. Yeah. So what we learned talking to other organizations or vendors, we’ll probably since we don’t really do much like we trust our, the people we have contracts with the majority of information. So we’re assuming since that still takes up a space they were saying, it’s probably better to just continue keeping them in the folders. Does that make sense? What I’m saying?
Nicolle Hepp (02:43) Yep. It makes sense. Just.
Karis Price (02:44) Focus on the ones that we internally credential and don’t credential by proxy, which is around that. What’d you say? 131 30? So.
Nicolle Hepp (02:54) Makes sense. Yep. Focus on the one 30. And then, are you guys, are you a single location? So I’m assuming single state with your payers, usually that’s like, you know, 10 to 15 payers, is that accurate?
Karis Price (03:08) There are, I have multiple locations, but it’s all in the same state of Kentucky.
Nicolle Hepp (03:18) Great. And then when you say credentialing, that certainly can mean a different definition to different people. So I just wanted to confirm with you guys is credentialing. Are you looking at verifying those primary sources or are you also referring to everything involving like pay or enrollment applications as well? We kind of have those in two different buckets. So just want to hear what exactly you guys are looking for in terms of a solution for those.
Karis Price (03:43) Yes, and I do the hospital initial credentialing. We do have… two other employees that handle the payer. I know they’re getting overwhelmed too with just the amount and, you know, when one provider goes to, they’re credentialing basically at all locations just because we have so much movement. So, I know that’s given them a lot of time there’s someone at the door. I’m gonna go check and see who that is, okay?
Nicolle Hepp (04:15) Yeah, absolutely. Let’s see. Well, I guess I can share a bit about medallion for you guys. So like I mentioned, we’re pretty much a provider credentialing solution. So we even handle getting medical state licensures for your providers, doing those primary source credentialing verifications, and then all the way through to pay enrollment applications to any payers that you guys are contracted with. So we cover that whole solution and we put that into our platform. So it’s as easy as for you guys, letting us know like, hey, I have a new provider joining need them to be enrolled with, you know, Aetna, or medicaid submit. But really medallion is an end to end solution. So we’ll take direction from your internal team and then we’ll power it through the platform. And so with that, we can automate about 80 percent of the workflows. So primary source verifications, we can turn that out in under a three day turnaround time in the software.
Nicolle Hepp (05:23) And then when it comes to payer enrollment, that usually shrinks down by about 30 to 45 days if you’re starting from a manual type of process. So yeah, really the goal of our solution is to shrink those timelines. Do it quicker, do it cheaper for you guys and have you have less hands in the mix, but always want to make that differentiator that we aren’t just a self serve platform at this time. So we also have operational teams in house at medallion that can finish out any human element. So, for instance, like being the one sending that application to the payers, medallion does own that as well. So, have you guys come across the end to end model in your evaluation thus far? Is that something you’ve thought about a?
Karis Price (06:08) 100 percent that’s going to be a huge part when we’re just reaching out to different companies and seeing on the initial talks, it’ll just be us, but we really want to bring in our insurance credentialers for maybe a second or third meeting with the companies we’re interested in. So that’ll be a huge part. And I’m sure. I don’t even know if they know we’re looking for one like this. So I think that’ll be a huge side relief for them.
Nicolle Hepp (06:41) Yeah, absolutely. Well.
Karis Price (06:45) Our chief medical officer is requesting that we look at other systems to help us just because he knows how much we’re overworked so… that’s kind of the main, it’s fortunate for us because whereas it’s not our idea and we don’t have to prove the need for it, we already have a big person up in our organization who’s requesting this. So we just, it’s pretty much a done deal that we’re going to get something.
Nicolle Hepp (07:16) Great.
Karis Price (07:17) Which will definitely.
Nicolle Hepp (07:21) that’ll be, yeah, it’ll be super helpful.
Karis Price (07:23) We don’t have to convince anybody. We just have to find who’s the right fit for us?
Nicolle Hepp (07:28) Absolutely. Yeah. That’s great to hear that you guys already have the project in place. Did he happen to mention the CMO if there is any sort of budget that you guys are working off of that we can keep in mind?
Karis Price (07:42) So no budget. No, but I mean, it will price will affect probably our decision, you know, if we can find a cheaper company if they’re relatively the same. Of course, we’ll look at, you know, what all aspects, what you all have to offer, but I do think price will play a heavy role. It’s not, but it’s not anything we’ve budgeted for this fiscal year… but our CMO really wants it. So, Our new fiscal year starts October first. So if we do have to wait, we can just put it on our budget, for… October first kind of plan for it, right?
Nicolle Hepp (08:34) Okay. Good to know. So maybe later in the year implementation, but you guys want to do the evaluation process right now, correct?
Karis Price (08:43) Yeah, correct. And I mean, we might even start before that as well. We don’t know what we’re looking like. We don’t know what the market is… for something like this. So we’ll just compare with what we have… yep.
Nicolle Hepp (09:02) Absolutely. And is there a certain driver for you guys either internally on your team or from the CMO, of why you’re trying to get a solution? Is it mainly for efficiency purposes or is there perhaps any like revenue delays that are attached to that right now?
Karis Price (09:21) I would say there is revenue delays for sure. A big part for our initial hospital credentialing is there’s been a lot of turnover. Just we’ve had probably four different people in cares has been with us since November December. But before that, we’ve probably had four people in this role about every four years. And just seeing the there’s stuff misplaced mislabeled, there’s inaccuracies that we’ve noticed and it really affects the credentialing part just making sure everybody it’s… tracked and everything is accurate.
Nicolle Hepp (10:10) Yep. Absolutely. And, I shared how we shrink the timelines but another big piece is reducing any errors. So, because we have the software, the automation in place, the platform, our claims denials right now is sub one percent. You know, we have AI in the background that performs audits and things like that. So really any errors where you guys would be having to resubmit, is not an issue with medallion, which is always super helpful.
Karis Price (10:41) Awesome. I know there’s tons of times where we’re looking for something that we should have gotten an initial and we know we had it because they wouldn’t have been approved without it, but we can’t find where it is or it was accidentally deleted or saved somewhere else. It’s just very hard when multiple people are in these files that we created and we don’t really have a good internal system yep.
Nicolle Hepp (11:06) Yep. Absolutely. I hear it often. Well, I’d love to get you guys connected on a deeper dive session. Usually, the next step is a 30 minute introduction to medallion with one of our executives. It could be even helpful to bring in any leaders from the payr enrollment side to get you both.
Karis Price (11:26) Eyes on the product. We could absolutely have somebody on our payr credentialing side in, on the call as.
Nicolle Hepp (11:33) Well, okay, great. I mean, I have my calendar open if you guys want to look at setting up some time next week or what do you want to look at?
Karis Price (11:46) Internally, I think I do want to move forward with another meeting. Okay? I do want to meet with some other teams and then talk to maybe our director and chief medical officer first before we set up some times, but I definitely think the interest is there on ours.
Karis Price (12:07) The last person we met with did kind of give us a… range of prices. Did we receive anything or is that something you’ll wait until you hear more from us?
Nicolle Hepp (12:21) Right. So the latter pricing, we can usually talk more about volumes and scope of services on the next call so that we can give you at least a ballpark by the end of that call of where you would land with pricing because it certainly ranges depending on what kind of solution you’re looking at and how many providers, how many applications things like that?
Karis Price (12:43) I understand. So. Is that something we could, you and Karis can work with like via email before until that meeting? So we can have on our next call we’ll have, we will have some ballpark figures we’ll know on the call. I.
Nicolle Hepp (13:00) Can I can try my best? I think Karis, if I could get you some inputs via email before that next call that I could pass along, I think that could help speed up the process there to get you guys into, that ballpark range.
Karis Price (13:16) Okay. Yeah. I can work through that. Perfect. Okay.
Nicolle Hepp (13:19) Wonderful. Is there anything else I can leave you with as you want to talk internally? I can certainly send over, you know, a quick overview or, you know, some of our average turnaround times, you let me know if you need anything, what?
Karis Price (13:32) Yeah. I am curious of what, obviously we’re talking to several different companies. What, what separates you all from the others? Why should we pick you over the others? What would be your reasoning?
Nicolle Hepp (13:44) Yeah, absolutely. I think compared to our vendors, a lot of them, they give you guys a software they send you on your way. Medallion is a true partner in such that we actually put in our contracts our turnaround times. And if we don’t commit to those times, there’s financial ramifications on medallion. So, for instance, I mentioned that three day credentialing turnaround time for primary source verifications that’s standard across the board. So right now, our average is under one day for a cred file to be turned out for payer enrollment, it’s 10 days to submit an application to each payer. So things like that we sign up for the outcomes. Whereas a lot of our competitors, you know, you guys will get a software you’ll manage internally. They’re not really signing up for those turnaround times. So I would say that’s our biggest differentiator, does that move the needle for you guys? Your?
Karis Price (14:43) Company, we work like hand in hand with our like payers with our credentialing payers on our side.
Nicolle Hepp (14:52) Correct. Yeah. We’d be a true partner. Like I mentioned, we have that human element operational teams at medallion, that work right alongside you guys, to finish out any applications and things like that to speed up the process.
Karis Price (15:09) And you have your own platform and it’s can you tell me like, is that, is it a good platform? Like it’s yeah.
Nicolle Hepp (15:20) Yeah, I like to say it’s a great platform. We, we automate about 80 percent through.
Karis Price (15:27) Software? Like, is it pretty intuitive? Yeah, user.
Nicolle Hepp (15:30) Experience is great. Can certainly show you a demo at a later point, but we have unlimited number of admins. Sorry?
Karis Price (15:40) Sorry for interrupting. Would that be in the second meeting or if or more exploratory meetings typically the?
Nicolle Hepp (15:45) Third? No.
Karis Price (15:46) Problem. Yep.
Nicolle Hepp (15:50) Easy user interface. Like I mentioned, mso staff, credentialing and payor enrollment teams can all access the same platform. They’ll have different viewpoints and it’s all customized. So each one of our clients has a different user experience based on, what they need and what they’re looking for. But yeah, easier to show you guys on a visual than talk about for sure when it comes, to user interface and the demo.
Karis Price (16:19) Well, I’ll definitely want a second meeting just because I want to know the prices. So consider… it. We’ll probably have something scheduled. We’ll talk and then we’ll probably have something scheduled for the next two weeks. I’d say, okay, that works for me. See what our insurance credentialer can do, what times sounds?
Nicolle Hepp (16:44) Great. Yeah, I look forward to it. Karis. I have your email, so I’ll email you over some of those inputs before the call, and then we can work around scheduling as well in the next two weeks. Does that sound good? Sounds?
Karis Price (16:58) Good. Yes, it does.
Nicolle Hepp (16:59) Great. All right. Thanks so much for joining guys. Have a great weekend. Thank you for.
Karis Price (17:02) Your time. Have a great weekend, yep.
Nicolle Hepp (17:05) Bye.
Karis Price (17:06) Bye.