Transcript
Brendan Cherry (02:43) Hey, Noah, my man.
Noah Laack-Veeder (02:45) Cheers.
Noah Laack-Veeder (02:51) Want to have some celsius. He’s getting ready?
Brendan Cherry (02:57) Yeah, a little afternoon, celsius.
Noah Laack-Veeder (03:02) That’s good. I’m a coffee Guy. I,
Brendan Cherry (03:04) love them, man. I’m like two a day on the celsius.
Noah Laack-Veeder (03:08) Hey, they got them at costco… say, again, they’ve got them at costco.
Brendan Cherry (03:14) They’ve got them at costco. I believe you, they have them on Amazon, so, I get them like shipped every couple of weeks.
Noah Laack-Veeder (03:22) There we go. A little subscribe and save five percent.
Brendan Cherry (03:26) Yeah, yeah, I’m fully subscribed to celsius?
Noah Laack-Veeder (03:31) Nice.
Brendan Cherry (03:33) Yeah.
Brendan Cherry (03:39) Hey, Valerie.
Brendan Cherry (03:48) I’m val, kieris, okay?
Brendan Cherry (03:57) Put a little something in the chat.
Brendan Cherry (04:13) Hey, Valerie. I’m not sure if you can hear us, but perhaps you’re on mute or there’s some audio issues, you ever know, with a, oh, you can’t hear us? Oh, we can see you. That’s a good start.
Megan Hastings (04:30) Can you hear me now?
Brendan Cherry (04:32) Yes, yeah. Coming through loud and clear, nothing from us.
Brendan Cherry (04:42) I can hear you.
Brendan Cherry (04:51) Yeah… we’re up. We’re down. We’re left and right?
Brendan Cherry (05:09) Still nothing well over the last 30 seconds. You may not have been able to hear us because we weren’t speaking, but…
Brendan Cherry (05:44) Hi, Megan.
Megan Hastings (05:46) Hello. How are you guys?
Brendan Cherry (05:49) Doing good. I’m doing really well, thanks. Oh.
Noah Laack-Veeder (05:51) Jeez. Still trying to get some audio in here.
Brendan Cherry (05:56) How are you Megan?
Megan Hastings (05:59) Doing well today?
Brendan Cherry (06:01) All right. Glad to hear anything exciting going on this week?
Megan Hastings (06:06) Lots of meetings.
Brendan Cherry (06:10) Nice. How many? Not too.
Megan Hastings (06:11) Much, oh, quite a few like eight tomorrow and six, the next day, I think so. Jeez,
Brendan Cherry (06:20) Louise, how do you keep track? Oh,
Megan Hastings (06:24) the handy dandy office three six, five.
Brendan Cherry (06:27) Oh, yeah. I look at it first.
Megan Hastings (06:30) Thing in the morning at five a. M, I’m like, okay, what’s my day look like?
Brendan Cherry (06:34) Does that help with like recordings and summaries?
Megan Hastings (06:38) I, it will, but I don’t really use that. I don’t use the recordings and summaries, piece of it?
Brendan Cherry (06:45) Oh, gotcha. Gotcha. Yeah, I’ve been, oh, no one knows this. I’ve been messing around a lot with Claude’s co, work over the past couple weeks and it’s incredible like how helpful it can be. Noah and I were looking, Noah. He might have mentioned this the last time but he teaches, he coaches high school track. We were trying to work out some app that could help him train his students. Yeah, that’s pretty crazy taking in some like data about their performance. Yeah. So.
Noah Laack-Veeder (07:15) My next one Megan is gonna be what should I eat per dinner app? And so I’ll just plop something in and see what it tells me to do.
Brendan Cherry (07:26) Yeah, I got a good one today. It actually worked for lunch. I made French toast but the bread is like no carbs, it’s all protein. So it’s actually somewhat healthy other than, you know, syrup. It doesn’t sound like bread if anyone wants the recipe. I’ll send it.
Noah Laack-Veeder (07:41) Hey Valerie. Yeah, we can hear you. Can you hear us I?
Valerie DeCaro (07:44) Just called it on my phone. Yeah, I don’t know. I have like six different speaker options and none of them seem to work with zoom. It’s an ongoing issue. Sorry about that. No.
Brendan Cherry (07:54) Worries. Oh, no worries. We got one working. So one’s all you need.
Megan Hastings (08:00) There you go.
Brendan Cherry (08:01) Yeah. How’s your week? Do you have a lot of meetings as well?
Valerie DeCaro (08:05) I do. Yes, we do back to back.
Brendan Cherry (08:08) Nice. Well, aside from medallion, what’s the most exciting topic?
Valerie DeCaro (08:16) It’s hard to pick one. It’s hard to pick one.
Brendan Cherry (08:19) You love all your children equally that’s.
Valerie DeCaro (08:23) right. That’s right?
Brendan Cherry (08:25) Awesome. That’s right. Excellent. Well, yeah. Thank you for both getting back together with us today. Much appreciated. Cool. Yeah. So, I know it’s been, you know, I know it’s been two weeks. We put together a bit of material and, you know, it’s kind of like a couple ways. I think we can make sure that this meeting is very useful for you both.
Noah Laack-Veeder (08:48) The I.
Brendan Cherry (08:51) think the, let me share what I’ve put together but it seems like some of the kind of key topics we wanted to focus on today and, you know, let me know if you had some other ideas but it sounds like the number one thing maybe to focus on would be the, you know, bottleneck for getting data and getting through the state licensing process. And what kind of like turnarounds could be achieved through medallion with AI and automation and specifically how we do that. So, we can show that today and talk about it in a bit more detail. And then, you know, I don’t quite know how to characterize this for you both, but it seems like maybe there’s some, you know, interest aside from, you know, the automations per SE as to how you could maybe leverage something like medallion to do tin consolidation which ultimately leads to delegated agreements. And, you know, that depending… on where that sits within your priorities or how much bandwidth you have, or something like that, we could look at that as more of a longer term and kind of talk about it as we explore like the payer enrollment automations, and say licensing automations, or we can make it kind of part and parcel and maybe that’s something we uncover together as we work together. But it seems like maybe the primary focus and where we should start is just looking at how the AI services and the automations can impact those turnaround times and ultimately get you through these processes quicker and ultimately make the providers billable sooner. Is that a fair summation? Is there, you know, anything else that you were keen to explore today beyond that topic?
Valerie DeCaro (10:23) Yeah, no, I think for us, you know, that’s a fair summary. I think, you know, we’re in a very preliminary discovery state at this point. So, I think, you know, just trying to understand better medallion’s process automation, and like how it supports that Roi will help us in terms of like guiding our next steps on how we want to move forward?
Brendan Cherry (10:44) Yeah, surely. And that’s kind of where our head’s at because these obviously sort of broad concepts, you know, great sentences, sounds good, but the devil’s always in the details, right? So, what I thought would be helpful today was, you know, based on the last call, I’ve kind of started to put together some broad assumptions in the workflow and I think it’d be helpful to kind of double click on some of the specifics there and that will better inform, you know, precisely where we fit in and what kind of results you could expect. And then coming out of, that leads into a better understanding of specifically like what an Roi could look like if we execute well on something like this. So, you know, depending on today’s conversation goes, I think we’ll have a better picture of that sort of thing. And the time I think it’d be best to use kind of like going into that as well as then kind of jumping into a demo and showing what some of these things look like. So, yeah, if we could would.
Valerie DeCaro (11:39) It be possible to maybe start with a demo. I’d really love to just kind of like see the whole offering from like, you know, start to finish. And then that’ll give Megan and I a good place to maybe start peppering in some questions on kind of what we know and what we’re looking for would be really helpful.
Brendan Cherry (11:53) Totally. Yeah, yeah. Let me, we can definitely can you guys see my screen? Okay? I know you see a bunch of slides here. So I don’t want to, you know, disregard what you just said, we can jump into a demo, but I do want to maybe before we do that, just get a very brief understanding if we have the workflow right? And I can share this with you after and, you know, potentially depending on today’s conversation goes, I can make some edits but it sounds like, I mean this is like kind of crude understanding of the workflow today, but I would say there’s maybe two ways of looking at this. They’re providers that are hired, right? And I know you guys operate in, I think 10 states and Ohio may be primary, so they may be operating in a variety of those 10 states. When they’re hired, there’s some data collection. I don’t know if we discuss these days, this is typically on average what we see from folks and through that they would go to state licensing, assuming they’re not already licensed in that particular state. And so that seems like the big gate that then would then once that’s through, kick them off to pay your enrollment and credentialing and ultimately getting them to their first billable day. Is this more or less accurate depending on the provider and whether they’re licensed already or not?
Megan Hastings (13:08) Yeah. So we tend to try even if as soon as they sign their agreement, we tend to have them kick off their licensing. So we don’t actually fill out the licensing applications like we put that back in the provider’s hands, sure. So it’s kind of simultaneously I guess the data collection and the state licensing, but we work with them, you know, if they need our help, we’ll help them. But typically they’re in charge of, you know, submitting that on their own. And then it’s kind of done at the same time. So it’s not one and then the other we’re collecting information at the same time they’re getting their licenses.
Noah Laack-Veeder (13:55) And then.
Brendan Cherry (13:55) Making, look what’s happened to my graphic, but yeah, that’s a good point. Sorry, no, I didn’t mean to cut you off, but I think that’s kind of, you know, at the crux of what we’re looking to solve initially is there’s this process that is somewhat out of your hands that you guide a bit, but that’s a big gate ultimately to getting them enrolled and billable. And so the question becomes like how do we fit in and help in that process? And so these… are the kind of broad workflows of what it could look like and we can jump into the demo and show, you know, exactly what the systems look like and how it helps. But sorry, Noah, you were going to add something?
Noah Laack-Veeder (14:31) Yeah, just making this quick question. So kind of what Brent and I are kind of thinking about and I know this would be a change, potentially is helping… with that licensing piece. So ultimately kind of what we’re thinking about is what if your organization was able to help the providers get their licenses by utilizing medallion’s automations and things like that? Ultimately, like what we were thinking of is if you provide that help via medallion to your providers, we have a very strong suspicion that we could get these licenses taken care of in about 20 days which would result in some advantages from revenue acceleration obviously. But then that would be a new process that you all would need to own. But I guess the question is that the Roi was there, is that something that you as an organization would be willing to do like help the providers? Or do you all still want to keep it with the providers to get the licenses done? I?
Valerie DeCaro (15:37) Mean, I think if there’s an Roi there, I think the biggest question for us is, you know, it sounds really good, but in 20 days, it’s kind of like I got to see it to believe it. So that’s kind of where we’re going with it. Like how are we getting to 20 days? Because that’s impressive if you can, but I think, you know, that’s what we’d want to see. Yeah.
Noah Laack-Veeder (15:56) So, Brendan, maybe you just let me share my screen now and then we can kind of talk about how we can do that.
Brendan Cherry (16:02) Yeah, absolutely. I’ll make this look better when I send it over too a little hacky while we’re live on the call.
Noah Laack-Veeder (16:10) You tried your best, Brendan, I wouldn’t.
Brendan Cherry (16:13) say that’s my best, but yeah.
Noah Laack-Veeder (16:15) Just so you know, I’m usually the one who’s doing the mapping in a different tool. So Brendan your powerpoint skills are good, but it’s the tool not you. Thanks man. So let’s go into it. Are you able to see providers on your screen? Okay? So there’s going to be ultimately, what I’m going to try to prove to you is like, hey, you know, medallion boasts that they can get these licensing done in 20 days. They say that you can get them billable in around 55 days. So like how is it all happening? The one thing I can say is based on the data, we processed about 100,000 licenses. So I can just tell you like that’s what our average performance is. But then the devil’s in the details in terms of how this all works. It all starts with how we’re organized as a platform. So what you’re seeing here is medallion as core for a provider data management tool. So nothing really revolutionary there. We just find that our UI is more modern and it really helps us both get information for providers and also update it and QA, it really quickly. So if I take a look at this, what you’re seeing is a I’d say, I don’t know bidirection isn’t the right word, but it’s a kind of like a one way mirror where providers are able to enter information into this tool. But then administrators on your end are also able to enter information for providers. So if I let’s say have someone who’s brand new, no licenses anywhere, this could be their first entry point into providing some information as well as storing any documents that are going to be necessary, whether it’s for licensing, for delegated credentialing down the road, or for provider enrollment. And just ultimately, we just what we’re doing here is storing all of your information in a modern interface and then connecting it to the broader organization. So if you have, I know we talked about seven different tins, multiple practice locations. You’re also able to connect providers to these groups. So everything starts flowing together outside of licensing use cases. So this is just the basics of medallion, nothing crazy yet it’s just a place where you can store provider data and get out of spreadsheets and shared drives. So I want to pause there. I know I don’t know if we learned a little bit about how you’re currently storing things today. But what tools are you using to store provider information and documents today? So.
Megan Hastings (18:51) we have a system. We have healthstream, credstream.
Noah Laack-Veeder (18:55) Yep. And so this comparing, it probably seems like pretty similar. I.
Megan Hastings (19:00) Mean, you know, this is very similar. So, in my previous life, I used qgenda. This is more I would say in line with qgenda’s platform, but credstream healthstream’s a little bit ancient just from a visual standpoint. But essentially, it does the same thing.
Noah Laack-Veeder (19:17) Okay. Yeah. And that’s usually? Oh.
Brendan Cherry (19:21) Yeah, sorry, no, I didn’t mean to cut you off as far as getting the provider information in. What does that look like depending on whether they’re like a new grad or maybe someone that’s coming from another organization? Yeah.
Megan Hastings (19:33) So we send, we don’t utilize credstream for that. We’re still kind of, we were not here. Valerie and myself were not here at the time that it was implemented. So we’re not 100 percent sure on what healthstream can and can’t do. So we don’t utilize it right now to send out, you know, because the way qgenda worked, we could send it all out through the platform. They could log in. They could upload their licenses. They could do all the thing. I do not think that they can do that in healthstream, but we’re not sure. So right now, it just goes out in an email with a welcome letter and a checklist of the things that we need from the provider.
Noah Laack-Veeder (20:09) And what I was going to say is typically, the feedback we get initially is like, yeah, this looks a lot like healthstream is a little bit more ancient. I love your words, not mine, but I agree. But then, you know, but the real piece that we’re solving for is that data collection as we’re talking about. So with credstream there’s usually a form that individuals have to fill in. And usually, what I hear is that there’s no integration with caqh or other data sources. Is that true? Is that what’s going on for you all today? Do you have any integrations? Okay? Yeah.
Megan Hastings (20:44) So, it integrates with caqh, we’re able to pull in that information and have it load into the system. Sure.
Noah Laack-Veeder (20:52) So let me just show you what it looks like for medallion. So what you do for us is you pretty much just say, look, I want to invite someone to the platform. And the only data that we need to connect this to caqh is a caqh id and some identifier. We don’t need their username and password, but we also make this part of the onboarding process. So it doesn’t seem like it’s kind of a new process. So what it looks like I’ll actually bring it up for you is the provider will get an email that says, and it’s going to be white labeled to you. It’s not going to say medallion, say welcome, and they’ll click this get started button which is going to prompt them to now do an onboarding flow similar to that form. But there’s going to be a key difference. It’ll be telling them a little bit about what’s going to happen here. But then they can kickstart their profile by getting their data from caqh. And again, all they need to provide for us is their caqh id, SSN, and their last name, they click verify. And then all of the information from caqh is going to get into medallion pretty much instantaneously.
Megan Hastings (22:01) Yeah. This is one thing that you have to understand what you import from caqh is only as good as what has been updated in caqh. So if our staff isn’t going in and updating the locations to the locations where we’re going to work, what you’re importing from caqh is not going to be accurate. So we have to go into the provider’s caqh load the locations where they’re going to be working for docs, and update it with the current information. Because if they were coming from a previous role and they didn’t have somebody that was reattesting their caqh and making sure their new cois were putting in there. The data that you import from caqh is only as good as the managing of the caqh?
Noah Laack-Veeder (22:40) Yeah, absolutely. So then what I’m hearing the solution today for that is, are you all like working on your provider’s behalf to update their caqh profile? Is that kind of how you’re solving that today? Yeah?
Megan Hastings (22:52) So in the checklist that we give them, we ask them for their caqh login and password, and that’s one of the first things that we do is we go in there and we make sure the new Coi that they get, that’s underneath our company, that gets loaded. So we actually don’t import caqh until it’s current. Because if we import it as is, we’d have to go into our system and update it to reflect docs information. Yeah, that makes sense. So it’d be like doing double work. Yeah. And.
Valerie DeCaro (23:19) I’m curious from your perspective, the handful of locations where I’ve had this that’s been the workflow where it’s like some providers, they don’t even know what their caqh profile is. So it’s like it’s been very hands off. So, is that what you typically see with other customers? Or do you see groups where the provider like owns it and manages their caqh fully? Yeah.
Noah Laack-Veeder (23:39) So that’s yeah, so really important question. So kind of Megan, I think this might be related to what the ideal workflow might be. And I guess the question is, and the assumption I’m making is across the board, providers probably least favorite four letter acronym is caqh. So we, our perspective is how can we make it? So providers don’t have to interface with caqh besides for the new folks creating their profile like that’s it. So what I want to show is kind of Megan align with what you said, the data is only as good as the data that’s in caqh. And if the kind of current reality is look the data that’s in there, we don’t trust it. We want to start from scratch and then we want to update caqh. The benefit of medallion is we can automate the updates at scale. So if you’re like look the best workflow for us is to just start from a blank slate, maybe use the import just to get it in here to have a starting point, but then update it that’s what medallion will do. So, let me kind of show you what that looks like is after we kind of go through that onboarding flow, Michelle’s profile will either be blank if we want to skip the caqh piece altogether or it’ll have information that’s already here. The next step is let’s make sure all of this data is correct before we start submitting either license applications or submitting payer enrollment requests. So with medallion, we do have automated QA that’s happening. So if I go, I’m going to show you this really quick. If I go to Michelle’s page here, what you’re going to see is that depending on what work we’re going to be doing for Michelle, whether it’s a license, whether it’s payer enrollment? We’re going to be automatically flagging all the issues that we might be encountering with her application. So for example, Megan, I’m sure you’re aware like you had to do this at some point, you need to double check that, is there information matching npes, right? Is it matching caqh? Is it matching fill in the blank source? And like you said, if the data coming in from caqh isn’t right? You either catch it up front or we want to catch it before we submit it out. The ideal workflow would probably be let’s just get the best data in up front, but that’s not always realistic, right? So what medallion will do is it’ll automatically scan all these different sources which payr is used to reject applications or state boards used to reject or kind of hold things up to make sure that when they are submitted, we don’t have those issues. So ultimately, Megan, kind of the workflow you’ve described is look, we don’t trust the data. Let’s make sure that this data is up to date. We work with our providers to get it. What medallion will do is now take all of this data and automatically update caqh. And then in that quarterly attestation process, we also automatically update and attest those provider profiles at that quarterly basis. But again, like you said, Megan, it’s a function of the data that’s coming in. But we will help you figure out which data is good and which one’s not good. And you talked about like those practice locations, we can load all these into medallion and then update accordingly into caqh as well. But ultimately medallion can be that source of truth that then updates the other sources of truth, which is very similar I think to the workflow you just described, Megan. So I’d just love to hear kind of any feedback from what I was talking about here.
Megan Hastings (27:12) Yeah. So medallion can’t like going back to you’re saying medallion kind of checks it well, the docs locations and all, that has to be updated in caqh. Medallion can’t go out and check that anywhere because it’s not going to be anywhere because we haven’t put it in caqh yet, no one is aware. None of the payers are aware that they’re going to be at docs dermatology now in Ohio at these locations under this tax id. All of that has to be loaded in caqh. So it’s not going to be checking it’s. Not going to be able to validate that because that information is not anywhere. So essentially like what our workflow is. Now, currently, we go into caqh, we update it then we go into credstream and we import it. So what is in caqh actually flows into credstream and it’s accurate. It is accurate to where they’re going to be working at for us. The only thing that’s going to catch for you guys is when you say, you know, matching all these things, yeah, it might go out and compare it to npez or, you know, whatever the payers have on file, but they know nothing about docs dermatology because it’s from their previous work history. It doesn’t have anything specific current that has to be updated. Now, I see what you’re saying where we can import it in, we can update it and then export it back out to caqh, right? I get, that, that’s what you’re saying too, but I’m just a firm believer like what I have going in my system, I want to be correct the first time, like I don’t want to import something from caqh that’s not accurate, and then rely on my staff to update it to docs information, our tax id and et cetera, and then export it back to caqh that’s just the workflow that works good for us. Yeah.
Noah Laack-Veeder (28:54) That makes a lot of sense. So just so I’m hearing you correctly, I mean I am a firm believer that it’s garbage in garbage out as well. So let’s like make sure it’s not garbage when we get the data. The first time, sounds like the workflow that you’re describing is, look, we’re onboarding a new physician. We need to identify which practice locations they’re going to be a part of. And that first data entry for you is to update caqh correct? Okay. So you could still do that. If you’d like a lot of what our customers do is they usually tell us like look here’s a list of all of my different practice locations that I have. And then they’re saying I want Michelle to be automatically part of all of these different locations. So we’ll either pre populate this for all these practices or you just add these practices one by one into their provider profile. And then we can push that out to caqh if we’d like it’s kind of like your workflow makes complete sense. And I think that could totally work. But a lot of our customers just use the kind of the linking and the, because if you do add practice, we already know all of your practices here. So it’s kind of like just checking which one it is. And then we’ll also be able to I’ll kind of jump into this piece as well. When you need to request a new payer enrollment, you can identify. Let me just do this really quick here. Just see if we got one.
Noah Laack-Veeder (30:25) Well, you can, it’ll automatically link whatever practice locations were part of that provider and link those to the payer enrollment application. So there’s no way that we’ll miss that location being part of that. So totally hear you Megan. I think it’s a matter of like how we want data to go. But ultimately with medallion, once that data is either loaded in the first time through medallion or through caqh, all of those relationships will be carried forth through the downstream work efforts, let.
Megan Hastings (30:55) Me ask you this if the welcome letter goes out to a welcome email, you know, invite the person and the provider goes in, puts in their caqh. And if we, on our end have already asked the provider in medallion, for example, with the locations that the provider is going to be at, like we already know this before the welcome email goes out, will that information merge? Because essentially that’s what healthstream does for us right now we enter the provider, we enter their locations, where they’re going to be, you know, here at docs, because it’s all set. It’s a web, right? So you’ve got your organization, you’ve got your locations, the organization’s under a tin under a broader network. And so whatever we’ve entered, I guess when caqh comes in, does it merge that information? Does your system merge it together?
Noah Laack-Veeder (31:48) Yeah. Ultimately, like the only decision point that we need from you is tell us what’s right? Right? Is it the data that we have preloaded or is it the data from caqh? And so how that looks is I’ll actually go to Michelle. Here is like you have the ability to say like here’s, what I have here here’s, what we could be importing from caqh. Tell me which one’s right now. This is a very fake example because Michelle and David, like we try to make it all look very different but you have that complete control. But ultimately, Megan someone needs to say what’s right? And then we’ll update everything else accordingly. So to your point, you have complete control over what’s going to be overwritten or not a lot of our customers, what ends up happening is like the value happens here, but also when we start submitting payer applications. So if you’re using caqh today, are you using caqh to submit any payer enrollment applications today? Well?
Megan Hastings (32:52) Payers use caqh. You don’t submit through caqh, payers go out and verify via caqh. So it depends on the payer. So some payers use caqh, and then some payers don’t so, yes, we utilize it when payers check it, but it’s not like we go through caqh and submit an application through caqh that’s not the way it works.
Noah Laack-Veeder (33:16) Yeah, some organizations from what I’ve heard, it’s a similar process. What I’ll say is if part of the application process is before you submit it, we want to make sure we update caqh with the latest and greatest data that we have. That step is done automatically through medallion. So then what the payer is doing is saying look kind of is going back to this little verification piece. Back to Michelle. Let’s go back to this. One of the things they’re going to check is like look is caqh matching everything on that? So we’re actually going to be automatically checking caqh and saying, is it updated? So in your case, given what you’ve told me, Megan, I don’t envision you having any of these errors coming out there’s. A lot of organizations that frankly don’t check these things. So this is their first step into, okay, like I even realized that all of this stuff needs to be done because maybe they’re working with a brand new payer they’ve never worked with before. But what we’ll do is since we work with every payer, we know every requirement whether they need caqh, whether they don’t but by default, having caqh updated is a great practice because the, most of the commercial payers require that anyways. So your workflow might be all green. But again, we’ll make sure we’re checking and flagging things in case you did miss something which sounds kind of in your process. Sounds rare because you’ve got that optimized. But back to the provider experience, the idea for them is that when they log in, the only thing that they need to do after you help them is sign the attestations. Like we’ve got everything in here. Great. I gave you the information. They’re trusting you to update caqh with the medallion. You’re not going to have to do that manual work. We’ll just connect and update after you work with those providers to get the right information. Ultimately. Like why this matters from an Roi perspective is with, I mean this is an average across workflows that aren’t as advanced as yours. Megan is, it takes less than two days for us to get all of the provider information in the system and checked for us to start doing peer enrollment applications. So it just really speeds it up… well.
Megan Hastings (35:33) It can, but somebody has to still go in and make sure the caqh so once again, it’s still only as good or as fast as us getting caqh updated.
Noah Laack-Veeder (35:42) I’d say it’s it says again, if you want to go the caqh path forward, you can. But typically, the workflow is, as soon as medallion’s profile is completed, we just feed it out to caqh and every other database that needs to be updated. So medallion ends up being the first.
Megan Hastings (36:01) Which is what other databases besides caqh and maybe enpass, what other databases are you referring?
Noah Laack-Veeder (36:06) To, yeah, so like so kind of like let’s go into like the licensing piece. For example, if you need to do a license application, like all of this information or some of the information is going to have to be fed into the state application, right? Same with payer, enrollment, might need to go to medicare portals, like paycoast might have to go to state medicaid portals. There’s going to be all kinds of places this data needs to go. So medallion kind of is like that first data center, right? Checks everything, you have your own checks as well that you’re talking about. And then we’ll feed all that data to the necessary places for licensing, payer enrollment, ncqa, cred, in some cases, appointments and privileging getting completed. So it’s kind of that central repository. So then when you go, hey, we need to do license for a provider. So let’s just say our Jennifer Larson is going to get a new license. You’re not going to have to remember, okay, like which state needs dacsrs, what are the applications going to look like? Because we’ve already collected all that data up front. We know which states they’re already licensed in. And we know that there are some states where they’re not licensed in. So let’s say, I want a new Colorado license. It’s also going to tell you since you wanted a Connecticut license, you’re also going to need a CSR in that state because they don’t currently have one. So what I mean, like the databases, is there’s the onboarding process to get this information in. And then there’s all the work that needs to be done with licensing with payroll and et cetera. Your role as an administrator, medallion would be submit the request and then the auto population and submission of the licensing, the primary source verifications for the licensing are going to be done automatically with a medallion. All of the follow ups are going to be done automatically through medallion. So the role for your organization is just tracking the status. And if there are anything that comes up that does need your attention, those would be a task that is assigned to the organization. So, I know there’s a lot there, but ultimately, yeah, go ahead Valerie.
Valerie DeCaro (38:15) Just a quick question. So I don’t know if we’re unique in this. I think our providers look to us for like a lot of hand holding, a lot of guidance on the process which we do because we want it to be successful. So like I can definitely see like once everything’s there, like how the tools can kind of help, the AI can kind of speed it up. You know, what does that like intake onboarding process look like? Because if that process is taking us like two to three weeks because our providers are used to, you know, essentially someone doing it for them. Like how do you work through that workflow challenge? Because that’s a big change management that I’m not, I don’t know how long it would take to get all providers on board with that level of change.
Noah Laack-Veeder (38:56) Yeah, no, 100 percent. Ultimately, the… how I think about this is in the ideal workflow. There are only two things that a provider does. Okay. Number one is they click that get started button and then they log in via sso. Like that’s the one piece, if you can have a perfect world where there are no gaps and no requirements of provider interaction, then we can skip to. Okay, all I need you to do is log into the platform in this mobile view. Let me just pull this up really quick. And what they do is they go in here… and they just sign the agreement that’s like the ideal provider in.
Valerie DeCaro (39:44) A perfect world. But like how do you actually get to that? I mean in a perfect world, yes. But how do you get to that?
Noah Laack-Veeder (39:50) Yeah. And I think since your providers need a lot of handholding in that case, I mean what we can’t automate is data doesn’t exist anywhere, right? Like I can’t automate that, right? I can leverage data from caqh, we can pull data via OCR technology from resumes and things like that, pull stuff from malpractice documents, they email you a bunch of stuff. We can auto populate things. But the ultimate thing that we’re trying to do here is equip your teams where you’re able to assist providers super quickly highlight those gaps that are keeping us from moving forward. And then once you get that provider’s data, the rest of the process is super streamlined and there’s no errors, delaying revenue. But again, I’ll… just comment on like the go ahead. So, for example, I’m sorry.
Megan Hastings (40:43) For example, let me bring up a, so let’s say our provider, you know, we ask for their CVS and the provider uploads it in their email. It says, get started here. Well payers and caqh, everybody is very picky about their dates. Okay? So, is that something that medallion catches if they don’t have their date format in the correct format? So instead of like a human having to review it, that’s something, medallion can review the CV and say, now, do you guys go back to the provider or do you come back to our team and say, hey, you need to go out to this provider and fix it? Well?
Noah Laack-Veeder (41:22) Yeah. So I think ultimately, the question is like, look if we upload documents or have other things and there are errors, can you catch it? And then how are you feeding that back to us? Typically, the organizations that we work with, we don’t send it to just the provider. Like that’s not the workflow typically because we just don’t want to like because to your point, Valerie, that’s not really solving the problem that’s just giving providers another task to complete when they’ve got time. So if medallion can automate it, right? And we don’t think we need provider intervention, we can reach out to you and your team and administrator and say, look, we noticed that these dates don’t match, should we update it? And if you don’t think you need provider interaction, we don’t bug the provider at all. You handle it on their behalf. The only reasons like in, is when we need to bug a provider, is if they give you a malpractice insurance that has expired and you’re like I don’t have anything updated, I can’t find an updated malpractice insurance. I’m going to need the provider to give that to me, right? And then if they upload it or send it to email from, you can upload it on their behalf. There’s no requirement for a provider to log into the platform other than signing that agreement because we need the signature that’s the one thing that we have a hard requirement for.
Megan Hastings (42:36) So that’s another piece we provide cois for our providers. There’s a medmal application that they have to fill out, which they have to do that. We cannot fill that out on their behalf. You know, that is, that adds at least a week. By the time the provider gets it, fills it out, sends it back. We send it back to our broker. They send it out to medpro. So these are type of things where you’re like, yeah, we can get them onboarded in three days. How like that’s? Already given you seven days right there. And that’s out of that, that’s like going through. So for me, it’s hard for me to, by end of this, I can get them onboarded in three days where there’s things that even medallion can’t control. You cannot make medpro go any faster. You cannot make the provider fill out their application any faster. So, these are questions that I have like when we’re saying we’re going to reduce your onboarding time to three days. These are questions I’m asking you guys. Well, how are you going to do it when these things are not necessarily even in medallion’s control?
Noah Laack-Veeder (43:35) Yeah. I mean, that is like a totally fair and I totally hear you. I think that’s where, you know, we can make these claims, understanding a little bit more about your workflow just makes it more real outside of the provider onboarding flow. Just commenting on the other pieces like the licenses and the payer enrollment. Let’s say that this does take two weeks for the provider onboarding flow. Like we can’t save you time there. Let’s say what I can do is make the tasks easier to find and update downstream systems quicker, right? Without manual intervention when we do payer enrollment and licensing though since we have all the data and since we have the integrations with the state boards, the automated psvs and things like that with the data that you’re providing that’s accurate, that’s how we’re able to get 20 day turnaround times because we have processed 100,000 licenses. So we’ve got this down to a science like we have the contacts, we do it in bulk. We know how to do that same thing with payer enrollments last year. We did 200,000 of them. So it’s ultimately, Megan, you’re saying the most important thing which is data in has to be good before we submit it’s. Got to be good. Your process is ironed up. So I would say you’re the perfect medallion customer. I’m not just saying that because if your data is good, you’re not going to have these errors, you send them. You’re not going to be the outlier for our state license that takes 50 days. No, you’re going to be the outlier that’s doing it faster because there’s no back and forth for that stuff. So I feel very confident that we can make the licensing and payer enrollment process faster based on what you’re saying, you’re right? I don’t see how we can make the provider onboarding process faster necessarily, but I think we can make it less resource intensive by updating those downstream tools like caqh automatically. So is that like a bigger assessment? Valerie and Megan that I said there?
Valerie DeCaro (45:27) Yeah. You know, in full disclosure, Noah. So I briefly worked with medallion at my prior company and, you know, we try and I left before, you know, probably a year in, but I can tell you the feedback we had was that it was the same thing. We’re going to automate it. We’re going to speed it up. We’re going to make it easy, but the volume of kickbacks that got sent back to the team and the provider to update was just inherit in the workflow. I don’t know how we would solve for that any differently here. And if we can’t get to that, we can’t get to, I think like the automated pieces of it that really kind of help streamline and do that. So I think that’s where I struggle. It’s like I get the AI piece like once it’s enrolled and how you can kind of pull in the data and do all of that. But inherit in the workflow. I’m just kind of curious like how do you get that? So locked up in the beginning where it’s not.
Valerie DeCaro (46:30) So, I think that’s… where I have to get that disconnect of like how does that get resolved? Because I do see a place for AI in this and kind of how we can automate and do some things there. But I’m just trying to, I have to connect that to our skill.
Noah Laack-Veeder (46:47) Yeah. No, that’s totally fair feedback. And I can see, I can see that I think a couple of things. How many years ago, Ish, or was it recent? Like the medallion? Was it like a couple of years ago? Was it like in the last year?
Valerie DeCaro (47:01) I’ve been here two and a half years. So it was like, right? It was right before then. So call it three years ago. Yeah, which a lot can change, you know, a lot can change, yeah.
Noah Laack-Veeder (47:10) And I’m not, and this doesn’t excuse anything, but we’ve only been around for five years and like since three years ago, we’ve raised like 120,000,000 dollars like we are, I guess maybe that’s I think it might be 130.
Noah Laack-Veeder (47:24) But regardless, we’ve made a lot of changes in the last three years. So, some of the, I mean, but ultimately, what we can’t do is automate the issues that Megan you’re highlighting like if they don’t give you that, but I would say if you’re able to get that like our customers that have this locked up, I’d say have someone like you, Megan, who is the administrator or kind of part time working on this and making sure these things are taken care of. And then medallion’s doing all the foundational work. Like we’re the ones popping the application. We’re the ones scraping the information and making sure that these things are getting done on time Valerie.
Brendan Cherry (48:03) Out of curiosity, what was the company that you were at three years ago?
Valerie DeCaro (48:08) Midwest vision partners.
Brendan Cherry (48:11) Midwest vision partners. Okay. Yeah, I’ll look that up. It would.
Valerie DeCaro (48:18) Be great and I know we probably can’t do it but it would be nice to do like a proof of concept, but I remember then like there was a lot of mapping that went into play and like there was a lot of setup because I would really love to say like here’s one of our complex applications like let’s test it, let’s see like, you know, what kicks out what goes. But I don’t know. Do you have any thoughts like how would we do that kind of without having to do like an actual implementation and build?
Brendan Cherry (48:42) Yeah. No, that’s a fair point. Let me just make sure because I’ve been listening for a bit here. And ultimately, you know, what I’m hearing is like the onboarding workflow is like a very important gate before getting to any of the automations around licensing and payer enrollments with the onboarding workflow. I imagine there’s two broad populations. There are probably like, you know, potentially new grads that maybe don’t even have any profile in caqh, all their data is fresh. There’s probably existing providers coming from some other organization that have some information in there. Regardless. They’re all going to be starting with you at some point. And in that, there is some information that only you would have that needs to become part of their profile, like locations, for instance. And so, the big question is how do you synthesize all of this in a way where ideally you’re doing the work once of getting all this data correct? It flows everywhere else that it needs to in a correct format. And the provider intervention ideally is nothing if possible, but as minimal as possible. Assuming that there’s some data that doesn’t exist anywhere. And then they have to fill it out. And it sounds like there’s some additional things that we need to consider in this onboarding workflow. Megan, forgive me you had mentioned something that you said takes seven days the Coi. Yeah. So I think that first piece is something really worth understanding and figuring out what kind of turnaround times are then possible and what that work looks like for both of us both.
Valerie DeCaro (50:25) In a.
Brendan Cherry (50:26) potential implementation phase and then ongoing, and then how that feeds into the rest of these processes. And it sounds like getting this part right is really integral to figuring everything else out. Is that a fairly fair summary? Yes. Okay. Yeah, excellent, I would say, you know, at a high level, these are the things like, you know, Noah’s kind of been talking about. But the way to think about medallion in this instance is sort of as like a universal directory or a pivot point for getting all this information. And the biggest thing is just defining where is the best source of whatever particular information it may be. So obviously like the data around the facilities or locations that they’re in that would be coming from you there’s. Probably for example, good data that can come from caqh, like very easily like their first name and last name. That’s maybe an easy one. How do we synthesize that in the middle? Do it quickly figure out what we need to intervene, what the provider needs to intervene on, get that attested, and then get that data flowing to the downstream systems? And so Valerie, you had mentioned maybe it’d be interesting to look at, you know, an application that you typically see and maybe Noah and I can put our heads together and come back and think of something that we could do as sort of like a proof point there. Does.
Megan Hastings (51:42) Medallion link… API, connections to portals where applications or things have to be submitted via portals. And then does medallion also follow up on those for you? Yes?
Noah Laack-Veeder (51:58) We do both. Yep. Do you?
Megan Hastings (51:59) Set that up. So if I said, you know, I want this followed up on every 30 days. Is that like a setting or is that, how does it, how do I know how often it’s going to be following up? Is that?
Brendan Cherry (52:10) A follow up for like a payer enrollment or for providers? Yeah.
Megan Hastings (52:14) For a payer enrollment? Yeah.
Noah Laack-Veeder (52:16) And so, yeah, Megan, that’s a, yeah, I think the key step in this is payer follow up. So we actually have predefined outreach schedules for all the payers based on our data model. It says like let’s say it’s Aetna for example. And we say, you know, we’ve done X thousands of these and this is the best outreach schedule. We usually default to that. If you have custom outreach schedules, we can follow those. And then the means in which we’re doing it is, you know, AI is coming with agentic phone calls and things like that. We actually use virtual agents to conduct those follow up phone calls. So if you let’s say you had like 100 that you had to do, they’re all going to be happening at the same time across those different payers. And then what we surface back to you is the result, right? For medicaid, for example, status is on the portal, we have feeds that will real time update the status space in our, we call it portal scraping. But ultimately like, yes, we get that information for.
Megan Hastings (53:17) You, the other, I would say the pain point that we probably have and something I would like to solve for which we’re looking at different solutions but is re creds. So how can medallion help me with re creds? Because a lot of times, what happens is we might get an email and I’ll just tell you our cred inbox, we’re getting hundreds and hundreds of emails a day. So maybe because we only have a team of four, we’re a small team. So maybe they miss it. And the re cred is almost past due even though they should like, uhc is a bad one which I hate uhc, but they’re one that they do use caqh but they want to see a re, attestation within that time period of after they said this patient is or this provider’s up for re cred. And so if we don’t do it or if they go out to caqh and say they pulled the caqh information and something’s missing or whatever, then, you know, there we are. And if we don’t respond, then they lose their cred status. So what, how can medallion help me from a re cred status?
Noah Laack-Veeder (54:19) Yeah, we actually automate those for the most part. And then the second piece just in the spirit of your question, usually that’s resulting in some claims denials or write offs. Is that happening with the validations not being tracked or well?
Megan Hastings (54:33) Not that’s it’s not a huge problem because we’re sliding by our teeth to get them done. There’s. We had some previous management and team in here before that we’ve had to change around and there’s a lot of been a lot of cleanup involved but I don’t think it will be a problem once we get more organized and have like we just got a fully staffed team within the last month, we had some turnover and things like that.
Megan Hastings (54:58) So I don’t think it will, but that is an area that obviously I’d like to prevent. So do you guys, do you, because essentially payers don’t give you recred dates, you can make the assumption it’s up to three years. Some of them are two, some of them’s yearly. So, you know, how do you go about that? Yeah.
Brendan Cherry (55:18) Very quick question. So, I know we’re just coming up on time. So with recredentialing, it seems in the past you have done a lot of acquisitions and it sounded like kind of nested in what you were saying is understanding maybe like the par status of providers that have come in through acquisition. Do you have good visibility into that today?
Megan Hastings (55:37) Yeah. We, so they join our team 99 percent of the time. So we do a payer gap analysis between what our payers are and what their payers are. And if they’re say they’re both under their legacy tax id, they’re you know, they’re par with uhc. Well, technically, they’ve already went through credentialing with uhc.
Megan Hastings (55:56) So all we do is provide a link letter because we’re linking them to our tax id. There’s not a full cred that needs to happen. So, yes, we do, we complete a payer gap analysis and we figure out, is there a payer that’s missing from our subset of payers that they saw previously under their legacy tax id? Then we know like, hey, we’re not par with this payer. We either need to get a contract or, you know, it’s null and void if the volume’s not there, but we typically do, we get those reports from the acquisitions up front and complete that.
Brendan Cherry (56:28) Okay. Excellent. And Noah, do you want to briefly address the revalidations bit? And then maybe we can, I know we just have a couple minutes we can.
Noah Laack-Veeder (56:36) Yeah. I think Megan high level is like similar to you. We have to, I mean, we process revalidations and so each payer has a different revalidation window. So based on like once we get an effective date, we use our rules and say, look it’s, uhc, has a three year revalidation window. We’ll track that revalidation date. And when that’s coming up for renewal or revalidation, we’ll alert you. But most of our customers just say, can you just automatically get the revalidation set up? So then what ends up happening is we just process the revalidation if there’s any new data or caqh attestations that are required. We’ll do that as part of the revalidation so you can kind of just like assume.
Megan Hastings (57:18) But how do you know when it’s coming due? Are you making the assumption off of, you know, uhc is usually a three year re cred time frame. We’ll.
Noah Laack-Veeder (57:27) make assumptions, but also verify that with the payer. Yeah. Okay. But again, yeah, we’ve processed just as many revalidations. So it’s again, it’s like we have these relationships, these economies of scale. So we just kind of have, I’m not going to say better assumptions. I just say we know the revalidation windows for the payers. Okay?
Brendan Cherry (57:53) So maybe I would say, you know, there’s a couple of bits here. There’s a, you know, obviously some more detail to get into in terms of like the onboarding of providers, but, you know, our, we have, you know, essentially the provider profile which you can think of as universal directory and through that feeds licensing, credentialing enrollments. And because we’re managing those, we have some sense of like, you know, the revalidations and recredentialing cycles and we have slas for the things that we can control like submission timelines and then averages around the different entities that you’re working with.
Megan Hastings (58:26) From.
Brendan Cherry (58:27) Where I sit, it seems like as part of your onboarding workflow, you know, if we have, you know, a one day average three day SLA, but there’s a piece of it that maybe drives out to seven days that we have no control over. You know, there may be like a four day gap, give or take… and we need to solve what that looks like. But where I see the real Roi is the potential turnaround time decreases in things like licensing and potentially enrollments. And so to that point, I think there’s a couple of things to follow up on just to kind of, you know, in the next couple of minutes sum up one was Valerie had mentioned looking at, you know, maybe us coming offline and looking at the things you need to get sorted from an onboarding perspective in more detail. And we can figure out, you know, how to come back to you on that if you give us an example, whatever that may look like. So we’ll write all this out for you. And then secondarily, some things that may help us be more prescriptive, we could send over like, you know, we can look up the states you work in, but understanding, you know, maybe the providers that you work with. So instead of talking on average about all the providers we work with, we can talk specifically about the ones where your providers are enrolling. And if we get that kind of information from you, I think Noah and I can put our heads back together and come back with a plan that would include validation steps and a little bit more precision on how medallion impacts all this stuff. Does that seem fair to you?
Megan Hastings (59:53) Yeah, yeah, absolutely. If you guys can just put that together and send it to Valerie and I in an email and then her and I will review, and then we can go from there and set something up.
Brendan Cherry (60:04) Yeah, that makes a lot of sense. And, you know, this is what I’m talking about. There’s always a lot more nuance than just the typical workflows we put out, but it’s always a good jumping off point. So I appreciate the details that you’re able to provide today and, you know, your willingness to work with us on this. So, yeah, we’ll put together a little summary of things that will be helpful for us to come back to you with something much more prescriptive. Okay, that.
Megan Hastings (60:26) Sounds great. Thank.
Brendan Cherry (60:28) You. Awesome. And a minute to spare. So I hope all your other meetings are as exciting as this one, Megan time.
Noah Laack-Veeder (60:33) To pin all this lunch and all this other stuff in one minute.
Brendan Cherry (60:36) Any other quick questions, 60 seconds go?
Megan Hastings (60:39) Yeah, 60 seconds. All right. Thank you guys all.
Brendan Cherry (60:42) Right. Take care. Bye.