Transcript
Kimberly Buck (00:00) good afternoon. Good.
Bradley Eral (00:01) Afternoon. How are you doing?
Kimberly Buck (00:03) I am doing well. How are you? Doing? Well? Looks?
Bradley Eral (00:07) Like Catherine’s on as well. How’s it going? Catherine? Well, good.
Kimberly Buck (00:10) How are you?
Bradley Eral (00:11) Doing well, doing well. And Danielle’s jumping on as well.
Kimberly Buck (00:18) Yes. And I think that’s it for us.
Bradley Eral (00:21) Perfect. Good afternoon, Danielle.
Bradley Eral (00:28) Hello. Great to meet you. Great to meet you as well. So, guys, we’ll get to introductions here shortly, but before we do, I’ll say this, the goal of today is further discuss medallion your requirements and ultimately provide you with the information you need to determine look, is there enough alignment to warrant further discussion or not? And both of which are perfectly okay outcomes, but does that sound like a good use of your time today? Yes, perfect. So, Kim, all of you lead the way from an introduction standpoint? Sure.
Kimberly Buck (01:00) My name is Kim buck. I recently joined hawthorne health. I am the director of nursing. And along with me today is Danielle, I’ll let her jump in from there. Thank.
Danielle Lambert (01:13) you. Hi, I’m Danielle lambert. I’m the head of talent acquisition for hawthorne health. We’re currently myself, Katherine, our team nta kind of handles a lot of our credentialing and onboarding of clinicians and physicians and such. And so I’m looking forward to hearing from you. Thanks Katherine.
Catherine Yuzon (01:33) I’m sorry, I’m Katherine, I am the talent acquisition, operations specialist. So I onboard and credential the clinicians here.
Bradley Eral (01:41) Awesome. Appreciate it, Katherine. And by way of introduction, I’m Brett E rall, director of strategic partnerships here. And all that means is work with folks like yourself, help them understand where a medallion can or cannot help them out as they look towards like long term strategy. But with that said, I spoke with Nika in preparation for this and have a good understanding of like at a high level, what you guys are looking to accomplish obviously re, evaluating the credentialing process across your.
Bradley Eral (02:11) Organization, but at a high level, like what would success look like whether it’s medallion or other, but like if you look forward like six months from now, how would you know that this initiative was a success in your eyes?
Kimberly Buck (02:22) I’ll start, I think that’s a great question Brad. I think how we would look at it as if it were a success is that we are seeking to bring credentialing fully in house. And so we would use it as a tool or a support engine to support credentialing internally by helping us automate many of the searches that we would be doing by helping to make it easier for providers or clinicians to be credentialed by using some type of digital tool instead of manual paper, a solution that has to be transcribed more than once. So more like streamlining the information that we bring in house. And then it would have a dashboard that would help us easily know where we are in the credentialing process, but also in re, credentialing or expirations or notifications that we would need to know about. And it would be cost effective?
Kimberly Buck (03:30) Most of all, I might have, when I was originally looking at this, I was looking at it from the point of view of how many providers have we credentialed? How have we been credentialing on an annual basis? And we thought about the number of 2000. But if we look at a more realistic number, we probably may onboard maybe somewhere between 250 and 500 this year, new people where we have a 1,000 active in our database that we would be, I’m watching we’re recredentialing monitoring, gotcha.
Bradley Eral (04:06) That’s helpful. So it sounds like, oh, go ahead.
Kimberly Buck (04:10) Catherine has something they want to add to what that, what success would look like in six months too?
Danielle Lambert (04:17) I think that was a good overview. I think.
Bradley Eral (04:21) Thanks, perfect. So it sounds like the goal is ultimately to bring this you’re working with an outsourced partner today. And the goal is to bring it in house entirely. Yes. And then improved visibility. Sounds like something that’s going to be a driver here. Yes. And then I’m curious like from a business impact, I guess why bring it in house? Is it you have the visibility, but are they driving like slow turnaround times? Is it a cost strategy? Like we’d love to hear kind of what drove the decision to reevaluate how you’re looking at credentialing in general?
Kimberly Buck (04:53) I think we do a lot of it anyhow but we pay a company, who doesn’t do as, we do more than we think we should. Number one, number two, it’s not cost effective. Maybe maybe that maybe number two should be number one. We want to make it more cost effective period. So, and I think we would like more control over it because it would help us with timelines as well. We’re, and I should say, we are research sites, we do research in the home and we do research at community sites.
Kimberly Buck (05:28) So we don’t need privileging, you know, we don’t operate as a normal clinical office would, or medical office or a hospital with regards to credentialing, right? Our need, we don’t bill, we don’t bill, and we don’t privilege.
Bradley Eral (05:45) Gotcha. Okay. Don’t bill, don’t privilege that’s a helpful perspective. And just in like in the spirit of transparency medallion, we are essentially an end to end partner where we own the entire process, right? So it’s tech enabled automation first approach, but we do have a team of services that sit behind it. So like the output for us is an ncqa compliant cred file that’s complete for all of your providers. Obviously like your team’s not enrolling with insurance. So it doesn’t necessarily need to go to payers. But I guess my question for you is knowing that what’s driving this is you’re looking to bring it in house. And essentially, we would be an end to end partner, right? That blends software with kind of that outsourcing model. Like does that seem like misaligned? Like are we misaligned on kind of what you’re hoping for? Is?
Kimberly Buck (06:31) There any way to just leverage the software without the outsourcing part?
Bradley Eral (06:36) There’s not unfortunately. Okay. So.
Kimberly Buck (06:39) That’s good to know, right up front.
Bradley Eral (06:41) Yeah.
Kimberly Buck (06:43) For the portion that you can’t separate, I’d like to know how streamlined can you get it to support our model? And then what would the overall cost look like? If we could even understand apples to apples? Like what we’re doing currently today? And if there’s a better way or a cost efficient way to do it, we’d like to understand that as well.
Bradley Eral (07:07) Exactly. So our, oh, go ahead Danielle.
Danielle Lambert (07:12) So, I guess for full transparency too, we did get a review from your team a couple of years ago and they were trying to give us the caqh management which was something we absolutely do not need and that was very heavy and expensive additionally. So we ended up going with a different partner at that time just in full transparency. And then with where we’re at today too, we struggle with support and ongoing support. So we have the platform but Catherine has to manually enter every single thing into the platform. So she’s essentially doing it all, it runs on the back of their platform. But then if we need to put in a ticket, sometimes it can take up to like four to six weeks for a resolution or for follow up. So that I think is also a big pain point because Catherine has a lot of responsibilities and can’t just be constantly chasing down tickets. Yeah, things that might come through. So, I think that’s another big piece for us is just having that support and somebody, you know, if we were to continue with using an end to end solution, you know, such as medallion, what that looks like kind of the turnaround times, what we can expect from even just like account management perspective?
Bradley Eral (08:26) Yeah, of course. So I’ll start with turnaround time. So we have a three day SLA to turn around the compliant cred file. We average less than one day. I think it’s like point seven, five days to be exact, but fast turnaround times. And we actually contractually commit to the turnaround times as I mentioned with that three day SLA. And what makes us unique is if we miss our SLA, is like there’s financial ramifications to medallion. It’s not just a number that exists on an msa somewhere. There’s actually teeth to it to ensure that essentially we need to be an extension of your team support. What Catherine, you’re seeing today, that would not be the case with medallion like we’re going to automate all the obviously the credentialing dates, the revalidation dates, automate notifications to either yourself or the providers or both like whatever the preference is, 90 days or whatever the preference is in advance of the recred dates just to ensure that nothing rolls off. And then from a cost perspective, Kim, going back to your question, we would, we’re typically… thinking of a good range here. Don’t hold me to this.
Bradley Eral (09:40) And you said about 100 let’s see, you mentioned 200 to 500 providers new a year, and then you’re going to be re credentialing, you know, another, what do we think about?
Kimberly Buck (09:53) A 1,000?
Bradley Eral (09:53) Okay. A 1,000 re credentials. So I’ll give you just a broad range here.
Bradley Eral (10:10) Yeah. So at the, I think a realistic like a good landing spot and this could go up slightly or down slightly, but would be about 150,000 dollars because our credentialing files are about 100 dollars per provider, right? And you know, why there’s why do folks pay that premium is because we are that, you know, fully managed service, you don’t have to continue to have to build out a large team internally.
Bradley Eral (10:37) And then Catherine give you time back. Like what you’re doing today is especially in an outsource model like unacceptable, right? As far as like not what you signed up for. So we want to take that off your plate as far and have to own the process and free up your team’s time for like more strategic onboarding activities as you look at like the ultimate provider experience.
Danielle Lambert (10:59) And then you, I’m sorry. Go you.
Kimberly Buck (11:03) Go, I was going to ask about the caqh as a follow up. You go. Okay, I am.
Danielle Lambert (11:08) Looking, I mean, I see the proposal we received previously and I have it and it had like medallion core which this was before I started, but I was like looped in to this. We had already signed a contract elsewhere but I was looped into this. I also had the medallion core, ongoing monitoring, caqh management, and then the ncqa credentialing. Yeah. And so can you kind of talk through like the different? I think, I know what they are, but just kind of what that?
Bradley Eral (11:34) Is, yeah, of course. So the core is essentially just a platform seat for your providers. It gives them the visibility because like a huge part of this is going to be visibility at all levels, it gives them access to the platform visibility in their recred and credentialing dates. And then just all the reporting that comes with that ongoing monitoring is like sanction checks, right? Make sure that you guys don’t find out about anything about your providers in the news, right? Let’s be proactive with it. Caqh management. I agree with you entirely unnecessary. In this case. I mean it’s a nice service, right? Don’t get me wrong, but that would be us fully managing all your providers’ caqh profiles, making sure they’re up to date doing the quarterly attestations on their behalf. So it’s like it’s a very nice service providers love it. But I view it more as like especially if you’re not doing direct enrollments with payers that’s where there’s a lot of value to have the caqh accurate. If you’re not doing that. I just, I don’t think it’s worth the investment in my opinion. And then the credentialing is of course turning around those ncqa compliant credit files.
Danielle Lambert (12:40) And the providers would be in the system directly then including like putting all of their information in the platform to run the credentials.
Bradley Eral (12:48) Yeah. Exactly. So what makes us unique? And we can set up a follow up session to show you what this would look like. But we actually capture, we have integrations with caqh. So as you onboard providers, we’re going to capture a lot of this information that already exists elsewhere to complete their profile. We’re going to assign tasks if there’s certain if there’s something missing. But for credentialing specifically, that gives us just about everything we’ll need. From a credentialing standpoint, we’ll just have your providers validate if it’s accurate information. But yeah, your providers will have access to the platform and can keep their profiles up to date if anything needs changing. And then I guess question for you guys as you look at bringing this in house, then from your current model to like a software model, like what would that look like as far as is there intention to build out a team to support that transition? I guess what’s kind of what does the game plan look like around bringing this in house?
Kimberly Buck (13:42) Yes, if we brought it in house, we would have to have the manpower to support that for.
Bradley Eral (13:48) Sure. And then in your experience knowing like your volume, what are you guys forecasting from a like what would this look like to build out? I guess how many team members would you expect?
Danielle Lambert (14:02) I don’t know that we like determined that, right? That’s kind of what all this process is for us to figure out what, you know, what avenues to take and what that, what makes sense.
Bradley Eral (14:13) Yeah. Well, the good news is what I can do is obviously, we come across this scenario a lot typically in like the inverse where folks are, they’ve built out a team internally, they purchased the software but realize like there’s maybe some limitations and it’s almost like a, you know, many of these are like kind of glorified task management tools. But long story short, we have a lot of data into like what it would look like to support your volume if you want like the software approach. So I can provide some context in our next call around that would look like. And then I guess the final question today is how long is this taking to credential your providers? You mentioned like speeds like an important aspect, but how long is that process taking today with your partner?
Catherine Yuzon (14:54) It depends on the provider and the verifications that are run, some turn around same day, just in a few minutes. Some might be 40 hours or if there are issues, it could be a month or so.
Bradley Eral (15:07) Okay, perfect. I.
Danielle Lambert (15:08) Think we determine like our average if we had to put one is about close to probably 14 days. Okay? But you kind of through the full like I mean, that might include some of the other onboarding aspects, but really kind of to get them through, you know, that whole piece kind of what we’re saying is our average, yeah.
Bradley Eral (15:25) That makes sense. And then once that process is complete, is that like, you know, once credential is complete, then your provider is immediately delivering care at that time.
Kimberly Buck (15:36) Well, pretty much close to it. You know, they don’t deliver care and research but yes, they’re conducting research.
Bradley Eral (15:42) Oh, yeah. I suppose. So, yeah, that’s thank you. Thank you for the call out there. Poor word choice. But yeah, I think like, based on this discussion, I think there is some alignment as far as improved visibility, improved speed, as well as like the outcomes for driving again like taking you from 14 days down to one day. I guess the one question is knowing a little bit of a departure from kind of what brought you here in the first place. As far as the goal to bring this in house, would it make sense for us to set up a follow up session to walk through the platform, show you the visibility you have or is knowing that we’re kind of the end to end model? Is that a hard stop for you from your guys’ perspective? I think.
Kimberly Buck (16:26) We’d like to, based on what you’ve shared with us so far. I think we have a twice weekly call. I think we’d like to take this back internally and discuss it and see at some point if it’s worth a follow up call. And if we think so we could reach back out to you.
Bradley Eral (16:40) Yeah, no, that sounds great. Yeah. Let’s do that. I’ll send over some information on medallion. We can keep it to a follow up session. Just let me know like again when it makes sense if it makes sense for us to schedule that, and we can obviously coordinate that session when appropriate. I.
Kimberly Buck (16:58) Think there is one question I’m still fuzzy around with caqh. We talked about it, but I felt like you kept saying that is your platform providers will enter their information into caqh. And then from there, that’s how you’ll streamline the, that’s what you’ll work from your credentialing platform. Is that your warehouse, what you’re using caqh?
Bradley Eral (17:19) It’s not our warehouse. It’s an integration source for sure. So, if your providers, if you hire a provider who has a caqh profile, we’re going to port over, we have an integration, a partnership with them. We’re going to port that information into medallion. And that way, like again, if there’s information we can capture elsewhere, we’re going to capture it elsewhere before reaching out to the provider. So they don’t start with like a blank slate if you will. And then the provider will come in. We’ll ask for any missing pieces of information and then validate what we did capture. So helpful if they have a caqh profile, if they don’t not a problem, plenty of ways to get information into the platform, but that’s kind of where the caqh comes in. And then that management tool or partnership we have for service. I should say that’s where we’d actually own the entire caqh management process of building your provider’s profiles, updating attesting and it’s a, you know, it’s a great service, but I think potentially overkill here.
Kimberly Buck (18:15) Yeah, we agree that’s why I kept asking. So just to clarify again, if they have a profile, you’re going to get information. But if they don’t have a profile, you’re not going to make them fill out a profile for caqh.
Bradley Eral (18:27) Exactly. They won’t have to make a caqh profile. We’ll just have them, we’ll task out like, hey, here’s the information we’re going to need from a medallion perspective to kick off credentialing?
Kimberly Buck (18:36) Great. And will they be able to enter that digitally or is it on paper?
Bradley Eral (18:40) Yeah, digitally picture like turbotax as well. They can do a QR Code, take a picture, send it in. It’s a tech first approach just to make it as easy as possible for your providers. They could mail it in if they would like. But certainly not an option many people take.
Kimberly Buck (19:00) Thank you. Will they need a separate login?
Catherine Yuzon (19:03) To complete their profile? What was that? Will they need a separate login to complete their profile?
Bradley Eral (19:09) Will the provider? Yes, yeah, each provider will have their own login to medallion.
Catherine Yuzon (19:15) And there’s like no, just plain application link. We can send them.
Danielle Lambert (19:20) There it’s.
Bradley Eral (19:22) a fair question… because we.
Catherine Yuzon (19:25) currently have many platforms that we need to have them create logins for. So I’m like wondering if we need them to have another login?
Bradley Eral (19:32) Yeah, exactly. And then what platforms are you guys using from like an onboarding perspective? We have our own.
Catherine Yuzon (19:39) Platform. We call it the visit delivery platform. We also have other systems that they have to complete training on.
Bradley Eral (19:45) Yeah, exactly. So there’s a few options there. Option one is, I guess there’s several options, right? But option one is we can integrate with those tools, right? And if you’re already capturing this information, we can just integrate, port it over to medallion option two or kind of somewhere in between. We could have your team like help manage these profiles for them. Like, hey, we’re missing this piece of information and collect it from your providers. And then the login option three would be your providers do get a login to medallion. Okay?
Catherine Yuzon (20:17) So, with the company we currently use, I am entering their information to the system. They don’t we don’t have an API integration with them, I believe your company does. But do you also offer like an excel import to import the data?
Bradley Eral (20:32) Yeah, absolutely.
Bradley Eral (20:40) Yes, that’s an option too. An excel import.
Catherine Yuzon (20:43) If we did an API integration, how long would that take? I?
Bradley Eral (20:49) Hate to answer with it depends but it certainly depends. We’d like scope that out from as far as, hey, what would be needed from both sides. So I can’t give you a firm estimate. But, you know, typically, I’m thinking of like implementations where we have deployed integrations anywhere from like a month to three months for like some very complex enterprise wide integrations. But what we do is set up a scoping call and the output would be a very clear timeline of, hey here’s what you can expect from a implementation perspective or timeline perspective, and.
Catherine Yuzon (21:24) We’d still be able to use the system during an API integration, correct?
Bradley Eral (21:27) Yes, absolutely.
Kimberly Buck (21:32) As a follow up question, where Catherine was going is how long does it usually take to bring you on board from contract to implementation?
Bradley Eral (21:45) Yeah, that’s I’d say anywhere from eight to 12 weeks. If I’m in your shoes and like speaking to the business, I would rather err on the side of caution and say 12 weeks. Okay? And then what do you guys need a system in place by?
Kimberly Buck (22:02) 30 days, 30?
Bradley Eral (22:04) Days? Okay. Yeah, that’s a.
Danielle Lambert (22:07) I mean, we have to notify our current within the next 30 days and that’s to give them a 60 day notice. So we do technically have 90 days.
Bradley Eral (22:18) Okay. Fairly.
Danielle Lambert (22:20) Quick. Yeah.
Bradley Eral (22:22) No, that’s helpful perspective. Well, let’s do this then, knowing that kind of tight window, I’ll let you give you guys an opportunity to follow up internally.
Bradley Eral (22:29) And then my recommendation is if you feel like there’s some alignment here, as you connect internally, let’s set up a demo sooner rather than later. That way you can assure from like a technical operational perspective, it feels like there’s some alignment and we can work from there. But at this point in time, would anything else be helpful for you guys?
Catherine Yuzon (22:48) You guys, I think so. Oh, go ahead, no.
Kimberly Buck (22:51) You go, I was gonna just pose, do you make?
Catherine Yuzon (22:53) Potential phlebotomists and sonographers?
Bradley Eral (22:57) I will have to confirm that. Was it, did you say phlebotomists?
Catherine Yuzon (23:02) Yes, phlebotomists and sonographers?
Bradley Eral (23:04) And sonographers. Let me confirm both. Of those. I believe the answer is yes, but don’t want to misspeak. Okay?
Bradley Eral (23:18) Awesome. Well, thanks so much guys. I’ll keep an eye out for a follow up if it makes sense on next steps here, but we really appreciate the time.
Catherine Yuzon (23:25) Thank you too.
Kimberly Buck (23:26) Thanks bye.