Transcript
Hassan Zahir (00:00) I don’t know if they’re in the room or not, but if they are, can you give me like 45 seconds to walk upstairs to my office? Yeah?
Cliff Marg (00:05) Not yet. You’re good?
Hassan Zahir (00:10) Sitting here watching the news and seeing this plane that ran into the fire truck at laguardia and I’m like, holy shit. I was just there Thursday.
Cliff Marg (00:21) Yeah, that’s a little spooky. Was not a fan. I was also watching the news and watching our beloved Hawaii underwater.
Hassan Zahir (00:30) Yes. I mean, I’ve been talking to, I mentioned that to Derek and to Kyle. I hate to say, fortunately for this, but fortunately, a lot of this is oahu and not. Maui had some like light flooding last week, but Teresa’s… uncle lives in oahu and she’s got cousins in Maui and they were all saying though, like it’s pretty much okay in Maui. Wow, that’s way too bright. They were saying it’s okay in Maui right now? Okay?
Cliff Marg (01:00) That’s big. All right. Mandy is in the waiting room. I’m going to let her in. Honestly, we don’t really have any collateral for privileging. So I’m going to try not to share my screen at all. Okay? But I may just like end up being like Austin. Why don’t you talk through like how we approach privileging if?
Hassan Zahir (01:16) That’s all right. We can keep it conversational, and then we can set up the next call. Cool.
Cliff Marg (01:21) I don’t know why I get the vibe that she’s not like super friendly, but let’s see what we got. Okay?
Cliff Marg (01:42) I’m Andy.
Cliff Marg (01:48) I’m trying here. There we go. Good.
Amanda Hedrick (01:50) Morning. Well, I guess, good afternoon now.
Cliff Marg (01:53) Morning for me. Are you in Louisiana? Okay. Yeah, yeah, good afternoon. That was awesome. Yeah. Thanks for hopping on and taking a few minutes to connect. Hopefully you can hear me all right? I’m at my parents’ house, all good in Arizona and the WI fi can be a little bit spotty.
Amanda Hedrick (02:14) My internet apparently is having a temper tantrum as well.
Cliff Marg (02:17) Okay. All right. Maybe it’s yours?
Amanda Hedrick (02:19) I may say off video. It seems to be working better without.
Cliff Marg (02:22) Okay. No problem. Cool. Well, we’ve got 30 minutes here. I don’t know that we’ll need the whole thing for today, but I think just to kind of set the stage like our end goal is really to learn a little bit more about kind of the telehealth group at ochsner, kind of how you are approaching privileging and really just kind of share a little bit more about how medallion’s working with some similar orgs and just trying to align on like is there a fit, is there something kind of worth pursuing and further conversation warranted or not? So that’s kind of the goal for today. Does that sound all right for you?
Amanda Hedrick (02:55) That’s fine.
Cliff Marg (02:57) Terrific. And then maybe just to kick things off, Hasan and I can do quick intros and then Mandy would love to hear from you as well. Sure. Perfect. So, my name is cliff. I’m on the partnerships team here at medallion. I’ve been here almost coming up on two and a half years. So working with a lot of our existing customers as well as prospective customers, just evaluating, you know, are there ways that we can help optimize a lot of times? It’s credentialing, sometimes it’s licensing, sometimes it’s privileging processes. So looking forward to connecting, I actually met Rochelle… a few weeks back at vive and that’s kind of what started this conversation was just a conversation around, you know, how you guys are doing things today and would love to ultimately hear from you. But it sounded like some manual process, some issues with turnaround times and just maybe some areas that we could help with. So excited to chat, I’ll pass it to Hassan.
Hassan Zahir (03:50) Yep. Thanks cliff and Mandy. A pleasure to meet you. My name is Hassan Zahir. I lead the solutions consultant team here at medallion. I’ve been here. I guess I’m a one week shy from two years at medallion. So kind of exciting kind of scary that it just goes that fast kind of to show, you know, how fast life is moving. But I’m super excited to talk through just kind of what you’re doing in a privileging space like cliff said, see if there is a there there. And if not, then we can part as friends and you’ll know cliff and Hassan from medallion and you’ll know what we do at medallion and, you know, no harm, no foul.
Amanda Hedrick (04:27) Perfect. Well, I’m Andy Hedrick, director of virtual care at ochsner. I am about one month shy of 10 years in the department. So I’ve had many roles. One, I started as just a nurse coordinator. I’m a nurse by background. I did bedside nursing for 10 years and then came over to ochsner in the telehealth department and helped to, you know, do implementations in the beginning, mostly telestroke telepsych, and we have significantly grown since then I started our virtual urgent care program, started hiring directly with ochsner. We used to use third parties for our telepsych providers and we kind of built our own virtual provider network. And now I’m helping to oversee pretty much everything within our telehealth space. And so, from a credentialing perspective, the way my team operates is they are not part of our central verification office like our cvo, they are a little offset of it that they still report to telehealth. And so essentially, the way they work is anytime we have an external partner for our telehealth programs, which we have probably 20 or so different partners outside of our ochsner system that do not go through our own credentialing office. They help support those providers and service lines by doing the applications, getting all the documents needed and doing the individual applications for each facility. So they help support like neurology, psychiatry and emergency. Some of our pediatric departments have programs outside of our ochsner walls, so that’s kind of how they function from a credentialing standpoint. So.
Hassan Zahir (06:18) It’s about getting all those applications then submitted to the different sites based upon the requirements and bylaws of those sites.
Amanda Hedrick (06:25) Of their sites, correct? Okay.
Cliff Marg (06:30) Awesome. Yeah, that’s super helpful context. And I think, you know, for our conversation today, what Rochelle had mentioned was like and I guess this would be good to verify with you. But like telehealth providers, she mentioned around 50 today that are kind of servicing these multiple partners. She said, you know, expecting a lot of growth on the provider count side. And then if you can maybe speak to just like when you think about the actual process of getting these providers, you know, able to perform services with your partners… how long is that taking? And like just ultimately, where are you feeling like there is friction or potentially like room for improvement?
Amanda Hedrick (07:15) So if I’m being completely honest, most of the time, it takes longer for them to get credentialed at ochsner, than it does with our external partners, which is sad. So I guess to answer your first question, 50 providers is probably… I’d probably say it’s upwards to probably close to 75 80… pushing 100. Probably some of them only support like one external. So some of our pediatric programs only support like one hospital and it’s like five of them. So it just really varies on program and, but I guess the greatest issue is truly responsiveness from our providers. Like what we try and do from the get go is, you know, we do an introduction to the providers. We have the service lines kind of help us navigate that. So there’s that interaction and then we try to get every document or every piece of, you know, license diplomas like whatever it is that’s needed from the jump. And so Stephanie and Wendy on my team are pretty good about kind of knowing like these are all the things that any of the hospitals could need and then they can save them in their folder and then use them. But at the end of the day, like they don’t sign their documents. So getting them to actually sign the documents turns into being like one of the greatest benefits issues and just them responding to an email or checking their emails, you know. So, I mean, you know, we’re 100 percent remote. So we’re not going on site. So everything we do is virtual. So, I mean, you know, I hate to say it, but I think the greater problems we run into are like internally within our own system because the providers do all that themselves and they’re you know, like, and then each of our campuses requires a different document. So then the providers are getting aggravated because then they’re having to fill this out, you know, this out for this one, this out for this one and we have, you know, I don’t know, I guess we’re up to 40 different hospitals within our system now and sometimes each of them needs something different. So, I think it just becomes like redundant and they just get frustrated. And then now we’re coming in and we’re like, oh, we also need to get these dyed. And then they’re like, are you kidding me?
Cliff Marg (09:31) Yeah. So I.
Amanda Hedrick (09:32) mean, we, from my team’s perspective, you know, they kind of have like what they need from the perspective of like being able to obtain the documents most of the time and the service line leaders will help also, but, it’s really about just having to do this like the providers having to do it multiple times for our internal system. Like my team fills out every single piece of document they possibly can fill out for our external partners and just requires a signature for them for the most part. Yeah.
Cliff Marg (10:03) That’s great. And I think, you know, not dissimilar to what we hear from other groups is like just the process of gathering everything that you need from providers kind of being the most or like potentially the biggest hurdle, right? Like they don’t want to, they don’t want to deal with paperwork. Where are you? Where are you guys storing all of that, all of those documents? Is it like sharepoint? Is it,
Amanda Hedrick (10:26) You know, we have our own, yeah, we have our own drive like for each, I mean, like we have a drive internal to ochsner. So, okay, let me back up. So there’s they use, medstaff for their, like ochsner uses medstaff, and so they do save some documents in there, but we typically will pull them out of there. And then we have a folder for each individual provider that saves, you know, we save each of their documents in there. And then if it’s stuff that, you know, if it’s stuff that medstaff doesn’t have them, obviously, they’re having to get it directly from the folder. So we haven’t moved to sharepoint yet, for that kind of stuff, we still use our kind of like internal system, site. And then, what was your other question?
Cliff Marg (11:11) No, just like generally, like, where are you storing all of the stuff that I think you answered?
Amanda Hedrick (11:16) Yeah. That’s that’s it. And then, you know, for each campus, or for each hospital, like… we don’t have like an individual folder for each different hospital. You know, they have a spreadsheet that basically is okay. You know, it’s this service is going to be doing it. And so they have all the providers listed on a spreadsheet. And then they just kind of have a running list of all the hospitals. And then they just, we keep track and we have a document that’s shared between all of us on sharepoint for that. And it just kind of gives us like updates on there. So like either like approved or they’re going to board next month or, you know, still awaiting two peer references and, I don’t know verification whatever the case is. So, from, for an internal perspective for our, for ourselves, that when I’m because I own the relationship with the service lines, me, and the managers who work for me, so we can go back to them and look, hey, we need this like we need another peer reference like this peer reference isn’t responding. So, I hope to kind of like drive, that conversation with the leaders, if the providers aren’t responding and things like that. Yeah.
Cliff Marg (12:19) Got it. Makes sense. And then my last question for you and we can shift gears a little bit here is, how many folks are on your team that are kind of day to day, hands, on the process of like collaborating with providers and making sure that all of these, external like applications are being filled out and things like that.
Amanda Hedrick (12:39) Two for the, from the credentialing side, it’s just two. Yeah.
Cliff Marg (12:42) Okay. That’s what it sounded like. Okay. That, that’s really helpful. Yeah, I think like Hasan, feel free, to kind of jump in, on top of this, but like Mandy, from, for your perspective, like a little bit on medallion, we essentially are a, you know, technology, enabled services company is one way to think about it. But I think at the end of the day, what we’ve done is like we’ve built a better mousetrap and so, you know, hearing you talk about like, the biggest, areas of abrasion being just interacting with providers, gathering everything that you need up front. And then obviously, like ongoing, there’s always the next document that you need from providers. Like that is a big area where medallion has really leveraged AI and automation to help streamline this process. So, I think like we can give a couple of examples. But when we think about the time that it takes to onboard a provider, on the medallion platform, it’s typically less than a day. Now, there is some nuance to that obviously, being like, you know, there’s always a new site maybe that they need a new piece of information and medallion can help go out and get that. But we’ve implemented things like, AI phone calling, which helps, just with like outreach to providers. And I think at scale, that becomes something that’s pretty, pretty useful instead of just like bothering each provider via email, however often like using AI to help with some of that. We also have, you know, integrations with things like caqh to help pull in as much of that provider data. We’re able to pull things directly from, you know, state license boards, et cetera. So we’re doing a lot of kind of that upfront lift to gather as much of the provider data, as possible. And then kind of identify, hey, here’s, the couple of things that we need. Again, we don’t have like a magic bullet if we did. I think, I think ochsner probably would have been customers a long time ago. But in terms of like how we’re actually, you know, gathering everything. It’s like there’s still going to be some involvement from providers at the end of the day. The other piece that I think could potentially be interesting is just when we think about helping customers and larger health systems with, these external applications. Our technology basically has the ability, to, you know, we work with your team, we gather the applications for each, health system, and then has the ability to help map all of that provider data directly to those applications. So it can help your team just like eliminating kind of hands on keyboard work. So, so I just kind of rambled a little bit longer than I would have liked. But hopefully, that gives you a sense for, you know, the process with medallion a little bit and like how we think we may be able to help some of the just manual aspects, of all of this.
Amanda Hedrick (15:32) Are y’all, like more like supporting like the, like health system? Like would you, do you find that you’re helping like an ochsner with their own ochsner providers, or are you helping kind of the alternative scenario where it’s like my, it would be like what my team is doing for the external?
Cliff Marg (15:52) I would say it’s both, it totally depends but we have a lot of customers where like all we do, it’s very similar. It’s like all we do is the external applications helping their providers get privileged at the additional systems. And then, you know, medallion really started out, working with telehealth companies specifically.
Amanda Hedrick (16:14) So, I think.
Cliff Marg (16:16) We have a lot of, a lot of familiarity with that. And one question that I had for you Mandy, was in terms of licensing, do your telehealth providers get cross state licensed? Or are they typically operating in one state with, you know, whatever partners oh the bane?
Amanda Hedrick (16:30) Of my existence. I feel like, no, I mean, so we support, we have hospitals in Mississippi as well. So we try, we pretty much always have to get Mississippi licensed. We have one little hospital in Alabama. So we’ve kind of started getting licenses there. So we had previously had, a contract with a licensing company. But if I’m being completely honest, it was almost more painful, to use the company. And the reason, is they had to go in and I’m not sure like how y’all, do it. But like, you know, they had to go in and fill out an application, which essentially was the same application that they would have, could have just filled out one time on for like the Mississippi licensure, and then they still had to send all the documents to the company to it. It.
Cliff Marg (17:22) Was just, it was just.
Amanda Hedrick (17:23) A hot mess and it was a lot of manual work for them which they probably could have just literally done all the exact same things uploaded it to like the Mississippi board and been done. And said, now they’re sending it to a person who is then sending it to a person. And so I found it not worth the cost. So, the concierge still technically has the contract with them, but I have started to dissuade service lines from using it and just getting them to do it themselves. And then we became part of the medical compact in the midst of all this as well. So that’s helped a little bit as well with like a timeline and then Mississippi, them doing it straight through Mississippi. It’s also like,
Hassan Zahir (18:00) the time?
Amanda Hedrick (18:01) Is cut into like a quarter of what it used to be. I don’t know what they did differently, but if you just even go straight to the board, so it, it’s still the pain of like it’s really not like that and y’all probably see this. But like it’s really not them doing the application. It’s them doing the fingerprinting and getting the stuff notarized like that’s where the hang up always ends up being. It’s really it’s and, this is kind of across the board for all of our stuff. It’s the stuff that they actually physically have to do themselves that we just cannot like force them. Like I literally one time did, a day of a notary coming on campus and them doing it and like it was a huge turnout and it actually got all kinds of licenses done and we did a notary and a fingerprint on site. And so that was like the way we ended up getting a bunch of providers doing it, cause to like get them to go do it on their own time is like literally pulling teeth.
Hassan Zahir (18:59) Yeah, no. And honestly, Amanda, that’s the reason why medallion exists honestly is like those sorts of organizations with kind of those antiquated methods of performing these functions as you can imagine like medallion. So cliff saying we built a better mousetrap Louisiana, the state of Louisiana and I know for certain, but the state of Louisiana for sure supports electronic finger prints and we have a partnership with printscan. We have a partnership for E notaries for E notary where you have a notary located in the state that you’re in. We’ve developed so many efficiencies to really hasten these processes to you. To your point, we get the provider’s information, one time single pane of glass. You can see everything that’s happening from a care site application. I’ll say care sites at a hospital, but from like a hospital application perspective or from a license, getting a license, renewing a license perspective. All of that is done in the medallion platform because we’re partners with caqh and we have integrations with npaas and some other external data sources. We’re able to populate a lot of that information upfront, a lot of like how you said your team is working to do it, but we don’t have to manually capture anything. We’re not keying in information like that. We’re populating everything that we can populate when they upload documents, we extract additional information off of those documents and use that to map to their profile, so that profile data can then be mapped to those third party applications or those hospital applications. If you will, we track the requirements on a per hospital basis. And then we can make recommendations based upon the provider type and where they’re located. So are they likely to also need an application to the site or an application to the site and really kind of help map that process out. The goal of medallion is to get some efficiency gains there. And because we started in telehealth, we have all sorts of ways that we have advanced outreach out to providers when they are, as we call non responsive providers. So we’ve got conversations AI where we can have our conversational AI, make phone calls out to the providers that’s integrated directly into the system. Obviously, email outreach is integrated directly into the system. Text message, outreach is integrated directly into the system as well as having a dedicated portal for those providers that is mobile friendly as well. So they can just snap pictures of documents and upload those directly into the platform as well. So just touching on a couple of those things there, a lot of the pain and the frustration. That organizations have led us to the point where we are with medallion and if it sounds worthwhile, it seems like there may be some efficiency gains that we can support you with at ochsner as well. Yeah, and help.
Amanda Hedrick (21:48) Me understand, is it the technology or is there people involved, how exactly does it work? Would my people still be able to do it and just have this extra layer?
Cliff Marg (22:03) I can take that Hassan. Yeah, essentially, Mandy, especially for this use case, like it’s going to be the medallion technology that your team is essentially leveraging to help perform some of these like automated tasks. There are other functions like when we are acting as a cvo for our customers that like have a human in the loop, right? Just kind of overseeing the process. I think by definition for ncqa, like it requires kind of some human touch, but it depends on the use case where you’re either leveraging like medallion’s automation, or sometimes our operations team needs to get involved. But I think based on what we’ve talked about today, it’s like leveraging medallion as a like we’ve said a couple of times just like a better mousetrap for your team to kind of track and kind of manage outreach to providers and store documents and things like that.
Amanda Hedrick (22:55) Gotcha. And how do y’all charge? What is that?
Cliff Marg (22:59) Yeah, it is definitely bespoke depends on the use case, right? If we’re talking about potentially helping with some licensing or if it’s just kind of the privileging process. But we would essentially look at how many providers do you all have today? It’s like a per provider per year, kind of nominal cost, storing all of their data in the platform. And then if we’re talking about how we would define like privileging or hospital applications, you know, per application or per state license essentially. And y’all.
Amanda Hedrick (23:32) Like it would also help with reappointments as well, not just the initial, yeah.
Cliff Marg (23:37) Absolutely. Track the.
Hassan Zahir (23:38) Reappointments. The reappointment dates track the requirements. So you have visibility. We can notify the two team members that you have as far as administrators like when these dates are coming up. If there’s anything missing from the provider’s profile, if there’s anything that needs to be renewed in order to support that reappointment, so on and so forth. So what it does is a lot of that manual work is automated. It kind of up levels your team to focus more on like the requests and what’s missing. And if there needs to be some more white glove outreach like those sorts of things. So your team still owns the request. They still have visibility and everything that’s going on in the process. But those kind of have to be done every time manual routine sort of task, the medaket automation handles those.
Amanda Hedrick (24:27) Okay. Can I mean, is there like hypothetically let’s just say I have 100 providers, 50 of those like it’s 25 hospitals. The other 50 is five. Like could you give me some kind of like ballpark on like what a potential yearly cost would be?
Cliff Marg (24:46) Yeah, I could try it’s. It’s not as easy as I would like it to be. But my guess Mandy, is that based on that size, like you’re probably looking in the, you know, high five figures, maybe low six figures. That, that’s my guess. Okay. And so, you know, understanding, I think it sounds like your process today is like well compared to a lot of our customers. A lot of times we’ll hear like these burning issues that are causing like major revenue leakage, like glad to hear, you know, not quite to that degree for you all. But it does sound like, you know, potentially just some process improvements could potentially be useful both on the reducing provider abrasion side as well as maybe just helping your team operate slightly more efficiently. But I guess the question for you, Mandy is like, is it worth setting up potentially a one follow up call where Hassan can kind of walk through the product and just kind of show you what the workflow looks like and we can kind of get your take on, is this useful or not?
Amanda Hedrick (25:50) To kind of see it in action. I’m definitely a visual person and kind of getting an idea of what that looks like. So, I think, you know, I think, for sure, I think, you know, the only from a financial perspective, like I think it’s only difficult thing is in like, unless it’s going to like transform like a person, a human, you know, like a human like that’s how we’d have to like think about like, how could how can this work? So that, or is there like a we’d have to really think about how we would then use, you know, my team and how can we, you know, how could this potentially like help them to then do other things that would then potentially drive some kind of revenue if we’re going to, you know, invest in the additional costs?
Amanda Hedrick (26:33) But I mean, I would love to see, I would love to see a demo on kind of how this works. Perfect.
Cliff Marg (26:40) Yeah, I think that’s totally fair. And hopefully like coming out of that next call, we can start to have a little bit more, thoughts or kind of guidance, on what that potential like business case would look like just based on some of your feedback to the workflows. Yeah. Okay.
Amanda Hedrick (26:57) Perfect. Well, thank y’all, this was great.
Cliff Marg (26:59) Yeah. And Mandy, do you have your calendar up? We can potentially just look at like next week if that works for you? Yeah.
Amanda Hedrick (27:06) Let me see.
Hassan Zahir (27:10) Let’s.
Amanda Hedrick (27:13) see Wednesday.
Amanda Hedrick (27:17) maybe like 10 a M central?
Hassan Zahir (27:20) 10 a. M.
Cliff Marg (27:21) Central is eight a M for me. That would work. Perfect. Okay, awesome. So I’ll just send over an intro, an invite for, you know, 40 minutes or so, and then, yeah, we can kind of take it from there. All right. Sounds great. Thanks Mandy. Good to meet you.
Amanda Hedrick (27:36) Thanks, you too. Bye bye.