Transcript
Jack Schell (00:00) hey, Lindsey.
JulieMeyer (00:01) Hey, how are you?
Jack Schell (00:03) Good. Just so you know, I’m going to try and run this agenda like I normally would and let them bring up anything. I’m not going to like proactively bring anything up in terms of what they’ve been talking about recently, but if Doug’s not here, I will address it with Kelly and just like talk and see where they’re at. Okay. I’m going to start admitting them.
JulieMeyer (00:32) So, if we don’t end up bringing it up, how does?
Jack Schell (00:44) Hi, Julie.
JulieMeyer (00:46) Hi, good morning.
Jack Schell (00:47) Good morning. How are you doing?
JulieMeyer (00:50) I’m good. How are you? Good?
Jack Schell (00:53) Good… week’s off to a quick start here. So, yes, yeah, they all are.
JulieMeyer (01:03) And.
Jack Schell (01:04) then, I don’t think that you likely haven’t met Lindsey yet, but Lindsey’s the engagement manager aligned with pain specialists.
JulieMeyer (01:11) Hi, Julie. I don’t think we’ve met. It’s nice to meet you too.
Jack Schell (01:17) Hi, Kelly.
Kelly Martinelli (01:18) Hi, I’m going to try to get Kat on the call. I’m hanging. I don’t know by a thread maybe, but I’m hanging. I’m still alive.
Jack Schell (01:28) That’s good.
Kelly Martinelli (01:29) Yeah. Okay.
Jack Schell (01:32) And then, I know that we added Doug to these as optional too. Just curious if you know if he’ll join today or not. Okay, we can also Kelly set additional time with Doug as needed.
Kelly Martinelli (01:45) Okay. Yeah.
JulieMeyer (01:46) I think he’s in another call, so I don’t think we should count on him today.
Jack Schell (01:51) Okay. All right. Then we have everybody. So let me go ahead and share my screen.
Jack Schell (02:08) All right. So as we talked about in our first executive sync last month, just setting up the agenda for these calls, of course, at the top of the call, want to share any medallion updates that we have with you a bit late on the updates today, we are approaching the end of our quarter. So I actually anticipate next month in April, I’ll have a nice Q1 look back from things like our product roadmap and areas that we invested and had success in Q1 to share with you about where we’re making improvements. So a little bit later today there then of course, as always want to stop and talk about your priorities and how they may be shifting and changing. And then we’ll go into the execution readout so metrics for performance and then consumption review. Just how are you tracking against the services you’ve purchased and how are they being used today? And then we don’t have anything on our additional projects tracker today. But again, should there be anything that comes up that we’re working on outside of standard operations, then we would just track that there and make sure we have meaningful updates and we’re aligned on how that project is tracking. I did invite Lindsey to the call today as she has taken over several weeks ago as your dedicated engagement manager, Kelly, I know you’re familiar with Lindsey at this point and Julie and Lindsey, you both just met. But again, Lindsey and I are both here to support you and to make sure that we’re running smoothly.
Jack Schell (03:36) Of course, as always, you do have the support of our leadership as well. And likely they’ll join us here in a call maybe once a quarter, so we can have them touch base as well as a reminder, you know, from a product investment perspective, services investment perspective. These are our core focus areas for 20 26. So again continuing to reduce manual work, improve accuracy, turnaround times, and then kind of as its own standalone focus areas, expanding our privileging services as we’re seeing that become more and more of a requirement for a lot of our clients. So from there, I do want to go into the execution readout and share with you some stats that we’re starting to see as we begin to process work for you all today. Talk about that. And then we can get into any psa specific updates. So from an execution perspective, want to bring in these metrics prepare enrollment. So ensuring that we’re enrolling your providers efficiently. This data again lives with the medallion. And if you want a refresher on how to report on any of this yourself certainly can support you in doing so last month?
Jack Schell (04:56) When we met, we were just setting expectations for what we’ll track here. So now we see in March that we are starting to see some metrics. So in terms of enrollments that we’ve completed fully completed for you to date, that’s eight number of enrollments that are currently in progress with medallion is 70. The number of enrollments that currently are pending action from the psa side of the house is 25. So that means there’s likely tasks associated with those or profiles that need to be completed. The average task completion rate for the psa team is 10 days. You know, we are early in our go live with psa just a couple months in. So it is 10 is, you know, where we’ll see things because likely there’s some outliers from when we were onboarding and just getting folks stood up and completing tasks to complete profiles. Ideally, we start to see this completion rate go down now that we’re in and we’re fully working the medallion and tasks are being completed to move requests along. Then the next two are turnaround time metrics. The first is requested to intake complete. So our team can begin work on your submitted requests once intake is complete, which is why we want to track this. We want to make sure that once you request an enrollment that the provider is already at intake complete or it gets to intake complete. So we can start work right now. It’s 25 business days on average. So again, this is an area where we would like to see this continue to drive down and that providers are getting stood up quickly. Again some early outliers through implementation. Given that we invited providers, some of them might not have been totally familiar with medallion. And we know that provider onboarding can sometimes take a minute. So again we will likely see this trend down. But this would be something that we would request support on with ensuring that providers are completing tasks in a timely fashion. And then this last metric here for turnaround times is requested to completed. So how long is it actually taking from when your team submits a request to when the enrollment is fully completed? The average business days that that’s taking today or currently for your current requests that have been completed was 36 days?
Jack Schell (07:31) So, I know that we discussed and introduced these metrics as something that we’ll read out on a monthly basis.
Jack Schell (07:36) Last time we met. I’m curious if there’s any questions that you have with the metric updates today. I don’t have anything. Okay. 36 days is very strong. We want to, of course, now that we have some enrollments completed and we’re able to set this baseline, we’ll use this here and we’ll certainly keep track of things of how they ebb and flow. We of course, want to see all turnaround times staying steady at 36 would be great if we can get that down that’s even better. Now, one thing we talked about last time was I asked you all what metrics would be important to you? And you had hauled back to some metrics that you shared during the sales process with turnaround times and wanting to make sure that we are improving or beating those and likely doing things even faster. I sent them over to confirm with you that these were the right ones but I just wanted to surface them here today as well. So the ones that we had captured as part of the early discussions were listed here on the left. So your historical turnaround times that were shared with us. And then as we continue to process enrollments with and for paying specialists, I will track your performance by payer here so that, you know, how we’re performing for each payer, and we can see what those average turnaround times are per your request and in comparison of how things are improving and processing. So we’ve completed as you saw, we completed eight enrollments so far today. So there’s not a ton of data yet to share here. But again, as we ramp up and we continue to process more and more of your requests, we’ll have that turnaround time data to share with you. Is this helpful in terms of what you were referring to last time we met?
JulieMeyer (09:34) Yeah, I think so. You know, I think one of the questions that came up with this data is the numbers on the left with the historical time.
Jack Schell (09:44) And.
JulieMeyer (09:45) I know you weren’t part of the sales process. So you may not know this, but I think there was confusion on where those came from. And if those are actually accurate?
Jack Schell (09:55) So, yeah. So those were in the sales process. You’re right? I don’t know, I assume that these were provided to cliff and to the sales team, likely by your team, I would think. Okay.
Douglas Badertscher (10:15) Actually, just so you know, Angela told me no, those definitely weren’t numbers we provided and our numbers were better than that. And so she made a big stink about it that her numbers were better. And so all I know is Kelly will be my goal for if the numbers are meeting our standard going forward now. And my question in reverse is I had two new providers start in March, but, we’ve been working on credentialing for a while and are we coming along with those two candidate, dr garou, arias, garou, and dr harkia, are they moving along at a good pace?
Jack Schell (11:00) Yeah, I know that we talked about those and we marked those as priority. There were enrollments completed for both of those providers.
Douglas Badertscher (11:08) So we just have payers outstanding now that’s all we have… because Kat responded… because I was not happy that blue cross blue shield in particular wasn’t already approved for dr.
Douglas Badertscher (11:26) Garou. And Kat responded well, it’s approved. They just have to do whatever they do and that’s going to take 30 to 45 days and I’m like, but she’s here working now and I never got a response from that. It.
Kelly Martinelli (11:39) Was they had to load them and it takes 10 days is what it is. So once they’re enrolled, then they got to, they got to load them into the system. And that’s what was taking 10 days?
Douglas Badertscher (11:50) And so we’re like on eight days now or seven days.
Douglas Badertscher (11:55) so you guys have no leverage on loading?
Jack Schell (11:59) Loading in the, on the blue cross side? No?
Douglas Badertscher (12:03) All right. So another one of my things has nothing to do with you guys. I don’t think it was a misstep on our part. So, I had a candidate, I have a candidate in recruiting that wants to move here, dr, Christina michaud, and, you know, we spoke to her two months ago. It was her on site visit for her and her husband this week and they’re here. And at dinner last night, I said, so, how are you coming along with your license? Because I had sent her to cat to get her Texas license from Georgia. And her response straight up was, well, cat told me that I can’t work on my license until after she gets a contract signed.
Douglas Badertscher (12:41) Well, that’s nonsense. And so, my question is Kelly on that one? I’m going to have her reach out to you. She has fasttrack in Georgia. They participate in the fasttrack with Texas. So we need to in the compact. So we need to try to because she’s a surgical inclined physician already doing surgery. Her and her husband want to be in Austin as quickly as possible. She’s not a fellow, she’s out in practice right now, but she’s going to come here. So, you guys don’t really get in Jack. Your team doesn’t really get involved in that at all. And you’re just going to do the credentialing side. You don’t help on the license side?
Jack Schell (13:22) Today, that is not something that pain specialists is contracted for with us. We do licensing in terms of supporting, with new licenses and licensing renewals. But specifically, the way you’re set up with us today is just to handle enrollments, so, with payers specifically.
Douglas Badertscher (13:41) So, Kelly, let’s remember that if we future think we’re going to need that service, let’s understand that because when we talk about credentialing… and outsourcing it, I was referring to the whole department. And apparently, when the communications went forward, somehow… part of the department got left in the department, but just be thinking about that, please and advise me. I have no idea if their services are better faster. I don’t have a, I don’t have a viewpoint on that.
Jack Schell (14:17) I can share with you some information about our licensing services as well as what we typically see from our processing with certain boards for certain licenses. And we can start there. And then as you mentioned, just keep it on the radar for the future if that is something that you’d like our team to complete work for. Okay. While we have a moment, Doug, I also invited Lindsey to our call, who’s a pain specialist, dedicated engagement manager. So, Lindsey is working closely with the team on the operational side, and just wanted to make sure that, you know, you all met as well. So, you know, who is supporting with all of our specialists and work. So, Lindsey, I don’t know if you wanted to introduce yourself?
Lyndsey Farmer (14:59) Hi, Doug. Very nice to meet you. I look forward to working with you.
Douglas Badertscher (15:03) Nice to meet you. Where are you located?
Lyndsey Farmer (15:06) I’m in the Boston area. Great.
Jack Schell (15:11) Awesome. So, from there, I know we just did the metrics readout I wanted to quickly jump into if there are any specific psa related priorities or updates that we should be discussing as it impacts the partnership or the work that we’re completing… anything that’s top of mind or anticipated growth or even priority requests that are going to be coming through. It sounds like there’s some new hires. Now would be a great time to capture any of those specific priorities. Kelly, I don’t know if you had any that are top of mind that you want me to make sure we’re escalating with our team? I.
Kelly Martinelli (15:49) Think you have the crnas, right?
Jack Schell (15:55) The cnras, do you have specific provider requests that you’d like us to mark as priority?
Kelly Martinelli (16:01) I believe we gave those to you before the crnas, the.
Jack Schell (16:05) Four cnras.
Kelly Martinelli (16:06) Yeah, yes. Yep. Perfect.
Jack Schell (16:13) Okay. And then, Doug, this new hire that you mentioned what was their name? We can keep a lookout for them as they come through once they’re through licensing, and they’re going to be getting enrolled?
Douglas Badertscher (16:24) Dr, Christina michaud, M, ICH a UD?
Jack Schell (16:31) Okay, great. Any other specific priorities that come up as it relates to the enrollment requests that we’re working for you today?
JulieMeyer (16:43) Have we started anything with, and Doug, I’m drawing a blank on her name? Was it Amanda Reyes?
Douglas Badertscher (16:51) Amanda Reyes?
Kelly Martinelli (16:52) She needs a Texas license?
Douglas Badertscher (16:54) Okay.
Jack Schell (16:56) Okay. I’ve captured her name as well as… she’s.
Kelly Martinelli (17:03) thinking it’ll come through in April by the way she’s thinking it’ll come through in April.
Lyndsey Farmer (17:08) And she’s like a late summer start, right?
Jack Schell (17:12) Yes, probably August. Okay. All right. Sounds good. Well, to keep things moving next in the agenda would just be the last item which is just to do the consumption readout. So this specifically again as a reminder is the services that you’ve purchased and are utilizing with us and where we stand in terms of utilization today. So in terms of the first four services here, it’s access to the medallion platform. So number of providers, the monitoring for those providers for license aspirations and the caqh management. So those count right now are all for all. And then the specific payer enrollment services which we’ve been handling, provider group enrollment revalidations as they become necessary will be completing. And then any demographic updates as well that will be come through. So as of today, we are underway with enrollment requests and this is how we’re tracking in terms of consumption, you have of course, through the end of September for these services to get requests in. And we’ll continue to track here plenty remaining for what we need to accomplish today.
Jack Schell (18:37) Okay. We don’t have anything on our project tracker. And then, you know, our next steps, of course, you have your operational sync with Lindsay to work through any priority requests or standing requests that you may have questions on. We will have our executive touchpoint here in this forum. Again in April. I look forward to hopefully having additional product updates for you that in terms of where we’ve seen success in our investments in Q1. And then, you know, Kelly of course, continue to let us know what is of utmost priority to you. And we can work through any items in the standing operational sync. Do you?
Kelly Martinelli (19:16) Have any updates on the levels of the contracts? You know, where it says anthem, and I need to know exactly what products are underneath those.
Jack Schell (19:25) So the lines of business?
Kelly Martinelli (19:28) By 10? Yeah. So.
Jack Schell (19:30) The example that you sent the screenshot that you sent with the tins that’s where you would, you can see that in the provider profile under the enrollments and the locations that are associated with each provider?
Kelly Martinelli (19:44) Okay. What about the actual like payer name, you know, because you’ve got Aetna but I got multiple contracts that were not contracted with?
Jack Schell (19:53) The plan associations?
Kelly Martinelli (19:54) The plan associations? Yes. Yeah.
Jack Schell (19:56) So that level that plan associations is not captured within medallion. And that’s not something that will be shown in medallion plan associations because they are so specific to each client and they change on such a frequent basis in order for us to be able to automate and process as fast as we do. We’ve built it so that you can see the commercial enrollment. And then those locations that you’re talking about can be found on the provider profile. But that plan association is not something that is going to be captured in medallion. Okay?
Kelly Martinelli (20:31) So, I have a problem then because right now we’re using modio where we’re able to see that information. So when we go to schedule a patient, are we contract? Are we in network or out of network with that payer? And now I can’t do that now that we’ve switched to medallion. So that is our lifeline.
Jack Schell (20:48) Is that the… is that for scheduling purposes?
Kelly Martinelli (20:54) Yes, yes. And you have the no surprises act.
Kelly Martinelli (20:57) So we have to give them an estimate if they’re out of network. We have to do that. But my front desk staff has no idea if we’re on plan or we’re not on plan so that’ll affect our revenue on the back end as well. So, how do your other large clients do?
Jack Schell (21:11) That? So they do look at the location that’s associated with the provider and the enrollments, and then that should likely dictate the commercial plans that are associated with that contract.
Kelly Martinelli (21:24) But my front desk staff doesn’t they don’t know what plans we are associated with that we’re contracted with.
Jack Schell (21:34) So, are they verifying eligibility before scheduling?
Jack Schell (21:42) And is that… not sufficient?
Kelly Martinelli (21:46) Must not be. I don’t I’m not in charge of the front end. Remember, I’m compliance.
Jack Schell (21:56) Correct. Is there a system?
Kelly Martinelli (21:59) That everywhere I’ve worked, they’ve had everywhere I’ve worked, I can tell you there’s been a grid on what physician it is and what payer that they’re contracted with and the effective dates… whether it be an anthem, whether it be, you know, a humana, choice plan or a ppo, or a hmo, they’ve always had that… this is the first time that I’m hearing that it can’t be done. And I’ve been in business a long time.
Jack Schell (22:32) So, for go ahead Lindsay.
Lyndsey Farmer (22:34) Yeah. So unfortunately, like Jack was just saying because of the fluidity with the payers constantly changing the plans and adding and removing different plans, that is why as of right now, where it stands today, medallion can’t put that into play because it would just be ever changing. We wouldn’t be able to keep up with the changes. So while you may have seen that in previous roles, I would be anxious to see how accurate those were at any given moment because of the fluidity of the constant change within the payers. So really… when you.
Douglas Badertscher (23:18) say the constant change within the payers, what are you referring to? So.
Lyndsey Farmer (23:22) The payers? So what Kelly’s referring to as plan is essentially what the member is subscribed to. So are they an hmo or a ppo member? Are they a blue cross blue shield gold or silver member… which ties into the providers as well? But when the big scale, what I’m talking about is how when the payers change, they’re ever changing those plans. So what is blue cross blue shield silver today? In 30 days, 60 days, however long they might pull that and say, actually we’re going to make it blue cross blue shield horizon. So they’re constantly adding or removing different plan types or changing plan types. And that is just something that we can’t as of right now, we can’t keep up with that amount of change.
Douglas Badertscher (24:15) But we had modio in use and we used modio so that… our staff could track the call center. The offices could track where a provider was on plan already for appointment status. And there was many plan changes when we had modio as you guys have. I guess nobody mentioned in this conversion that we don’t have an automated way to update any list to get to our call center, which is essential. So somewhere there’s something missing here because every other company would have the same requirement. And what do we use? What list do they have? What can they grab could?
Lyndsey Farmer (25:00) I ask a question about and I’m sorry, I don’t know anything really about modio. But does modio have something like scheduling built in? Like are you using utilizing modio for scheduling type purposes? No, because that’s kind of what it sounds like is modio has something tied into their software?
Douglas Badertscher (25:21) No, but modio gives a view perspective for call center agents, center managers, regional managers to know where their physicians are credentialed with the payers so that we can load up cases and it’s an active, it’s active. So it’s a resource. We don’t have a resource right now.
Lyndsey Farmer (25:47) Right. And, I mean, I do hear hear… that it’s what it’s sounding like to me is that modio has something built into their software, their platform that is specific for scheduling. Whereas medallion doesn’t we don’t handle any type of scheduling. So like what you’re referencing and needing these plan breakdowns goes into scheduling where we have Sammy smith that is in network or is contracted with blue cross blue shield silver plan, and they need to see a provider that’s in network with blue cross blue shield, silver plan, that would be on a scheduling piece and medallion does not offer.
Douglas Badertscher (26:33) Yeah. So modio, we weren’t using modio for that, and to my knowledge, they didn’t have that either, what they had was an active plan that to show us where the doctors were credentialed when they got credentialed. Is that correct? Kelly? Correct?
Kelly Martinelli (26:46) Yes. Yeah.
Jack Schell (26:48) And so, and Kelly in the screenshot that you shared that information, we do have from what we saw in the sample, we do have all of that information in medallion. And I didn’t see the like plan associations in what you shared. And so I do think believe we can get you the information that you need. And we have that information in medallion, perhaps we need to set up the right report and have that delivered to you on a regular basis.
Kelly Martinelli (27:18) Let me show you it does have the plan in there.
Kelly Martinelli (27:27) Can you see the screen?
Jack Schell (27:29) It’s loading?
Lyndsey Farmer (27:30) It’s loading. Okay?
Kelly Martinelli (27:34) So, you can see, I’ve got it for Angela ash. You’ve got all the locations, okay? For Aetna. Okay? For this particular tin number. And then for this particular tin number, you’ve… got Aetna. And then you’ve got whatever this is Aetna choice network for.
Douglas Badertscher (27:54) Her, so,
Kelly Martinelli (27:55) these are all the aetnas, the different plans underneath this tin number. So she’s got a couple different tin numbers. You see there’s a two six. And then there’s seven, four there. Okay? But these are all Aetna plans and it tells me every location for that.
Kelly Martinelli (28:20) The problem is we’ve got multiple tins and so we have to be really careful with that as well.
Jack Schell (28:29) See this information. When I go to Angela ash in medallion, I do see Lindsay, correct me if I’m wrong, let.
Lyndsey Farmer (28:34) Me get there. Hold on one.
Jack Schell (28:35) Second. I believe I’m seeing that there’s information in there.
Kelly Martinelli (28:40) Well, probably not because when I get into medallion, they didn’t carry over to the implementation, the stuff that was already there, it didn’t come over.
Lyndsey Farmer (28:53) Let me see. I’m pulling it up right now. So I have,
Kelly Martinelli (28:58) to go in and I have to have the cat and Sonia manually put all of the old stuff in there because it didn’t come over as to what they were already in, you know, contracted for enrolled with.
Lyndsey Farmer (29:12) So, it looks like if so, it looks like when you go to the drop down on Aetna and Jack on Angela ash, it looks like it’s broken down by practice location. And then the lines of business over to the right are just the.
Douglas Badertscher (29:28) the.
Lyndsey Farmer (29:29) standard medicare advantage, commercial exchange, but.
Kelly Martinelli (29:32) It doesn’t give me by tin, either. See I have two different tins.
Lyndsey Farmer (29:45) Yeah, it’s broken. Yeah, here, I see that here, it’s broken down by practice location, not tin.
Jack Schell (29:57) Okay. I see the comparison.
Lyndsey Farmer (30:11) We were just looking to see if there was anything.
Kelly Martinelli (30:25) So, basically what you’re telling me is I have to manually keep track of where my providers are credentialed or contracted with for each one of these payers by tin. Your system does not work.
Jack Schell (30:39) Well, the tin should… be.
Kelly Martinelli (30:44) This is very confusing for people on the front end who do not understand credentialing, they just need one place that they can look.
Jack Schell (30:54) Do you see that? Okay, Lindsay, let’s take a closer look at the sample and… the tin, specific data points. I.
Kelly Martinelli (31:10) Would have never chosen your product because of this.
Douglas Badertscher (31:14) Yeah. And if we can’t find a workaround, Kelly, we’re going to have to be forced to truncate this service and go to another one. And because this just doesn’t it just doesn’t work and every company needs something. Now. I’m supposing that Jack, when he looks at this and Lindsay, they talk about it, that this can be converted into a report, excel, some other format and can be provided out on a frequency basis. That could work for us on a shared drive type of thing. But we have to have this.
Kelly Martinelli (31:51) Okay. I mean, I’ll be good if I can pull a report, but I gotta have it, have a report to pull.
Jack Schell (31:59) Lindsay, let’s look at the tins, take a closer look at the tins and how we can report on those. Okay? And then also just like revisit the import template to make sure they’re mapped correctly. Okay. All right. I know that we are, we’re over time, Kelly.
Douglas Badertscher (32:17) We’ll Lindsay.
Jack Schell (32:18) And I are going to look closer at the tin aspect here, okay? Because we see, we obviously see the enrollments but there’s this data point that you’re calling out that, of course, is necessary. Okay. So, any… anything additional before we hop here?
Douglas Badertscher (32:40) Nope, not from me.
Kelly Martinelli (32:43) Okay.
Jack Schell (32:43) All right. I appreciate your time. If any priority requests come up, you know, you can always let Lindsay and I know, and we’ll make sure that our team is aware of the priority requests.
Douglas Badertscher (32:56) Okay. Thank you. Thank.
Kelly Martinelli (32:57) You. Thanks.
Lyndsey Farmer (32:58) Thank you. Bye, bye bye.