Transcript
Josh Brunell (00:04) hey, josh. How’s it going good? Can you hear me? Yep. I’m gonna let them in now. Okay. How are you feeling?
Samantha Bouchard (00:15) You know, the ever evolving, I feel a little better today. Sun’s way out. I think… yeah.
Josh Brunell (00:32) Hi, Melissa, Lisa, Leticia. How are you? Hello?
Josh Brunell (00:42) How’s everyone doing today?
Leticia Stewart (00:48) That’s your answer right there. That was the answer.
MelissaFeliciano (00:52) So, sounds.
Josh Brunell (00:55) Like I got an excited crew today, ready for the demo. I think we’re just missing. Let’s see Marie.
Samantha Bouchard (01:13) Well, I highly suggest a diet coke and a Reese’s egg mid afternoon to shape up your day. That’s what I just had the Reese’s Easter egg things. Those are my favorite. So I’m all sugared up. I.
Leticia Stewart (01:29) Can’t mix like a sweet drink with a sweet thing like you have to like do those separately? Yeah.
Samantha Bouchard (01:37) It’s true. I think, I just, yeah, I needed all the sugar and I already drank too much coffee, so.
Leticia Stewart (01:44) I get to switch to coke.
Samantha Bouchard (01:47) Diet coke.
Josh Brunell (01:50) Great. I think we have a quorum. Are we waiting on anyone else? I didn’t see the invite get forwarded to anyone?
Leticia Stewart (01:59) Else. No, that’s it from our side. Cool.
Josh Brunell (02:04) Let’s get into it. So, appreciate you all taking the time. I know we have an hour. Not sure we’re going to need that whole time. Typically this, you can get a lot done in just about 45 minutes or so. So. Hopefully, we can get some time back into your day if there’s obviously additional questions towards the end though. I just want to make sure. Do you all have until the top of the hour in case?
Josh Brunell (02:32) Yeah, I’m okay with that. Okay?
Leticia Stewart (02:34) Cool. Yeah.
Josh Brunell (02:36) Yeah, we’ll try to get you out early though. And yeah, as far as agenda goes, just a quick recap of some of the things that we heard on the last call before we dive into the platform demonstration. Additionally, Lisa, I don’t believe you were on our previous call. Have we had the opportunity to meet?
Josh Brunell (03:00) You’re muted if you’re talking, sorry?
MelissaFeliciano (03:06) I’m not sure if her mic is currently working. I think she’s working with it right now.
Josh Brunell (03:11) Okay. Is just level set for me and Sam, what’s Lisa’s role in the org she?
MelissaFeliciano (03:19) Is the facility credentialing coordinator for one of our clients that we also do the payor enrollments for? Okay?
Josh Brunell (03:28) And when you say facility credentialing, are you doing also like facility enrollments with the health plans as well? Or she, I should say?
MelissaFeliciano (03:37) Well, I handle the making sure that the doctors are enrolled with the payors. And then she does her side of the facility, which is making sure that the doctors are privileged at certain hospitals.
Josh Brunell (03:51) Got it. Okay. Yeah. There’s a couple of different… ways that we typically see that process. So, yeah, once she gets her mic teed up, we can dive into that. But cool. Thanks for the context there, Melissa. You’re welcome. Yeah. Before we dive in, I just like a quick recap of some of the areas we heard and then how we’re gonna address some of these in the demo. So we heard, on the last call, I mean, very similar to many of our customers, right? A lot of moving parts, a lot of tools, spreadsheets, kind of siloed data. Sounds like your team is running into some challenges, as you’re scaling as far as adding more clients, there’s complexity in that, you know, you’re working across different states, different payers, and from the way that your model works is that you have credential, you have like kind of like, a lead if you will, that owns maybe two or three client accounts and then they’re and then responsible for kind of owning the provider onboarding enrollment process. And then Lisa’s team is then responsible for just the privileging piece, as far as like some of the challenges that you’re looking to improve limited visibility, manual processes have a lot of holes. That was one of the quotes I wrote down as far as gaps in coverage and obviously, that’s impacting your clients, your ability to place your clients’ rads and get them billable. And, and so, I just wanted to highlight these, see if there’s anything we might’ve missed before we dive into some of the ways that we’re going to show how we can improve some of these areas.
Josh Brunell (05:44) I think silence is a no, okay. So as far as like the ways that, I think that we can address some of the challenges around having many systems fragmented data, manual processes. Sam will be walking through the platform end to end. We’ll we’ll start with really how we get data into medallion with less involvement both from an administrative standpoint and on the provider side. How we do that. I think much quicker and more efficiently which will help ease that burden on your team. How we’re helping to automate some of the management of things like caqh, both managing that profile on behalf of your providers, as well as attestations… helping to automate follow up both on the payer side as well as providers as well when you’re trying to chase down some information, giving visibility within through our analytics into the health of a specific customer, essentially where you’re at within the process of getting their radiologists enrolled with various payers during onboarding process and then helping you effectively be able to have a platform that scales as you’re continuing to grow. I know you’re about a 1,000 providers that your organization supports today and that’s growing as you mentioned. And so our mission is gonna be helping you do that with the team in house today and then doing that faster more efficiently. So they’re driving better outcomes for your customers and driving faster revenue for them as well. Cool. So we’ll talk about the automation in place… a couple of things here. I’m sure you hear from vendors all the time. Well, you say you’re faster we see a demo. How do you prove it well as far as turnaround times? We do track this very closely across all of our customer base. And this is turnaround times across different variables. So when we’re thinking about like this is for example getting pay enrollment applications out the door in our platform. We’re constantly adding new automations and ways to collect provider data and get these applications filled out quickly and efficiently in an automated fashion. And are seeing an improvement as far as like getting apps out the door which right now is just under three days is our average and then for like application resubmission rates. So making sure that we’re not having bounce backs or resubmissions. This is consistently dropped as well. Year over year. I think this is we’re sub night 99 percent. And so the way that we’re doing that is because we actually have mapped out payer process guys for 900 plus payers in our system which Sam will walk through to ensure that we’re not making mistakes. We essentially have controls to not let you submit an application, knowing if there’s we don’t have a clean record or if we’re missing any sort of data so that’s built into the platform. And then this is also on the provider onboarding piece. Through our integration with caqh and other automated ways which Sam will walk through, how we’re getting providers onboarded, which used to take us around 10 days. Now, it takes just about two hours into the platform. So overall, we’re helping to drive revenue, reduce costs, remove provider abrasion, as well as just drive a better experience for your administrators. And I’m just going to skip forward here to what you’ll see in the demo which is we’ll start with kind of the provider view, then we’ll go into the administrative view and then kind of end with executive view within the analytics. Any questions for Sam before we dive in?
Josh Brunell (09:27) Not from me? Okay.
Josh Brunell (09:38) And Sam, you’re muted?
Samantha Bouchard (09:40) Muted and talking away. Can you see my screen? Yes, awesome. Excuse, my scratchy voice. I’m on like the tail end of a daycare illness for any of you that have kids. I’m sure you understand, but I feel better than I sound. So that’s good. Awesome. So what I want to walk you through is our demo today. As josh mentioned, we’re a comprehensive end to end partner that’s really going to efficiently manage your data collection from the time a provider joins one of your partners all the way through to enrollment and then doing those validations. And we’re going to do that faster and with less effort from your team. So we’re going to focus on three things today, how we accelerate the onboarding process, how we use AI and automation to process payer enrollment applications faster with less errors. And then how we give you visibility each step of the way. So one of the things I heard is that you are all kind of separately managing different partners for CV and you’re kind of each doing that in your own, you know, you’ve created your own spreadsheets, your own processes, your own payer guides. What I really hope you take away from this demonstration today. And if you do not please chime in and ask questions because I missed something, but I want you to see how all of this can really be streamlined and that you can maintain working on your individual clients. But with, you know, less of the kind of like the busy work and… less administrative effort on your side. So one question that I had for the team is we can set up your work a couple of different ways and I think I’ll show you the way that I just kind of set it up for the demo, but would love to see what would make what you all think would make the most sense. So essentially this is our landing page. You can see like I used one of your partners or one of your clients like northstar as the instance name. We could always put northstar’s logo here as well if that’s something that’s helpful for you. But essentially, we can set this up. So northstar has its own instance. And then if we look here in this list, I have like civie having its own master instance. So this would be like really high level reporting across all your clients. And then here were a couple logos that I pulled off your website. And I’m sure you have some additional partners as well. So we can set this up. So every single client has like their own instance or we can set you up in a single instance. And then you’re able to like organize the data more by teams? Is that tracking for you all? And would you all have a preference on how this would be set up?
Leticia Stewart (12:43) It is tracking. I do want to know if a provider reads for different, if we have it set up the way you have it presented here. And a provider reads for northstar, and they also read for another. Would that information cross over those clients or would it just be specific for the client we’re on at that moment?
Samantha Bouchard (13:07) It would be specific for the client that you’re on in that moment. But what we can do is that we can transfer. Like, so if that provider has a profile under northstar, rather than having them complete a separate profile under, you know, T, I think tpa, is that your other instance?
Leticia Stewart (13:26) It doesn’t matter. You can call it whatever you want.
Samantha Bouchard (13:28) Tra. Yeah. Rather than having another under Tra, we can just kind of copy that profile over so that you’re not having to like they don’t have to like reduplicate the data, but we are working on like having exactly what you’re mentioning Leticia, which is that concept of like a shared provider profile across instances. So that is on our roadmap for this year. But right now, we just kind of duplicate the data from instance to instance.
Josh Brunell (13:58) Even if.
Marie Ferailleur (14:01) it’s like a highlight or color or an asterisk, something to let us know this provider… also reads for a different client?
Samantha Bouchard (14:14) Yeah. There’s plenty of ways we could certainly notate that whether it’s a teams notification or there’s different notes and sections that we could certainly, we can certainly highlight that. So I’ll make note of that, and we can kind of highlight how that would look if, you know, we continue conversations.
Josh Brunell (14:32) I also have a question on the, for your clients, do you in the current system that you’re using today give them access like access to viewing like their information, because like some of our customers, they do, right? And so they would want them to have kind of like an administrative view of their own instance, some of them don’t and it’s more for your team from an organized like from making sure you’re organized across all your different clients. Like I guess, what does it look like today? And what is that something that you’re doing giving your customers access to this data?
MelissaFeliciano (15:17) Currently, with the Healthstream, the providers, I believe they do not have access. We manually enter the information in Healthstream and update it as needed.
Josh Brunell (15:32) Got it. And then I assume you send them like maybe like a status report that you export out of there so they can see like what enrollments are in process versus active?
MelissaFeliciano (15:43) Yeah, that, then that portion is done manually with an excel sheet because we don’t have that function to download that specific report from Healthstream.
Josh Brunell (15:52) Oh, wow. Okay.
Marie Ferailleur (15:54) Yeah. So it’s very, again, a lot of manual labor. You have to go into each client. Let’s say if I have three clients, I have to remember. Okay, I just updated this roster. I need to email this administrator, the updated roster. And as you can imagine, it’s not necessarily done on a weekly basis or daily basis if it should. But I do have a question with you guys, you can, we can allow them access. So let’s say if we’re missing some documentation, they can just go in and upload that.
Samantha Bouchard (16:26) Great. Segue. Yes. Yeah, no, it is perfect. Yeah. So will I really want to walk through this flow as if like you are adding a new provider to northstar, right? So we can just kind of walk through it. And then you’re doing all the payer enrollments for that provider quickly before I get in there. I will just highlight how we’re really going to structure in each instance, all of because you mentioned that all of these partners, they can have multiple tins, they can have multiple practice locations. And so where we’d have each of your instances set up like this. When you go into northstar, I just went on their website and kind of made up some group tin names here, but based on some of their practice locations. So you’d be able to see all the tins that are associated with northstar. And then if you go into the group profile, you would then see all the practices associated with that particular tin. You’d see the payers associated with that group. So if there are different group contracts based on the tin, that would all be displayed here. And then you will also see the providers that roll up to that particular practice and so they can roll up to multiple practices as well. But I like to show this. I know this is like, you know, just kind of like basic data structure, but it’s important as you all know, for payer enrollment. And sometimes in some other systems, this can be a little bit buried, a little bit hard to see and especially hard to report on. And so one of our like classic data architecture structures is really this provider practice group structure that allows us to efficiently process payer enrollment applications, but then gives you simple access to your overall data.
Leticia Stewart (18:26) Can you go back to that payer screen? I’m sorry. Yeah, actually I actually understand what you’re saying. So I’m a little more interested. Usually I am on the calls and I don’t know what they’re talking about. So… so how do we get this information in there? Is that like a person has to manually go in here and say, yes, we’re contracted with Aetna under this tax id number? Like how is this information getting in the system?
Samantha Bouchard (18:54) Yeah, that’s a great question. So, do you have this data stored in credstream today? Or is this some, is it between credstream and your spreadsheets?
Leticia Stewart (19:05) I have no idea. I don’t only a few people use. Lisa uses Healthstream, but she doesn’t do payr, so it’s kind of a mixed bag on what we’re doing today, but I want to be able to see everything in one quick view. I don’t want to have to reach out to Marie or Melissa all the time and say, what about this? What about this? I want to be able to go in there and say, yeah, I see it. Okay. Yeah, we have a problem with the contract with Aetna. Okay. Yeah, I see, you know, this doctor isn’t enrolled like I want to be able to just quickly see everything and I don’t want to look through stuff.
Samantha Bouchard (19:43) Yeah. There’s.
Marie Ferailleur (19:45) oops. Sorry, currently, none of that is in credentialstream right now. I know, for example, I have one client, I have their folder, and I have folders for each of the payers. So I just know which payers go with this client.
Leticia Stewart (19:58) Okay. Nothing.
Marie Ferailleur (19:59) Has been.
Samantha Bouchard (20:00) So for your existing clients, what we will do during implementation is we have an import template where we can bulk upload all of this data. So you would get assigned an implementation manager. You would also get assigned a technical solutions manager. They’re like our data like wizards when it comes to just like organizing and structuring the data. So they are there to kind of support that initial implementation transition. And so we would get all of your group contracts… all of your existing group contracts, all of that kind of loaded into the system. So it lives here on an ongoing basis. If you kind of miss one, it’s really simple. You just kind of come here and you add a group enrollment. So say, you know, you would just select the state the payer and then if they’re in par status and if you have an effective date and you can add some contract information as well. So super easy to do like a single manual entry, but we would want to upload this data in bulk for you at the time of you transferring like your initial client base. And then what we would do for your, as you take on new partners in the future is you would have access to that import template. And ideally, you know, you would work with your partner to kind of fill that out with all of their information. We would get that loaded in and then boom, they’re kind of ready to go from like a net new partner perspective. But I came over from implementation and we can certainly share that template with you. It’s not super overwhelming. It’s not super intense, you know, really easy to navigate. So just don’t want you to feel like how are we going to get this data? Because we do give you kind of like the resources to kind of map a lot of that information from the data sources that you have today.
Josh Brunell (21:59) Okay. Going back, Leticia, you said that you wanted to be able to quickly easily search for, you mentioned a couple of things like, hey, which providers is in network, which payr, we do have search function here. And I will just call out like both in the group section, the provider section or tabs on the left. And then analytics like quickly and easily you should be able to get access to any of those pieces of information either through like the search function here or if you just actually go into yeah or payr’s tab. So there’s a few different areas you can view this based off preference. Was there anything in particular like quick lookup wise or things that you typically would want to report on?
Leticia Stewart (22:41) No, like we’ll get a message from a client and it’ll say this location is in a network with this payr and it’s like, well, I don’t know, I don’t know what location you know, like different, just different queries, and I just want to be able to quickly, you know, see and understand. Yeah, I don’t see that, this location is under this payr. Let me, you know, let me find out what’s going on. Oh, yes, I see it. So I don’t know why the claims aren’t you know, processing or whatever. I just there’s a lot of different scenarios that we get and I just want to understand like the capabilities of really I’m looking for a simple and that’s me and I don’t work in here. So it’s really up to Melissa and Lisa, but, I’m just curious. Yeah.
Samantha Bouchard (23:33) No, it’s a great question. It’s a really common theme that we hear especially from like the billing side of the house. And so that’s why we have like this billing status. We’re going to list that out by practice location. And then anytime we do an enrollment on your behalf, so say we do an enrollment for five locations, we get the par status but we’re only seeing three locations. Medallion is really going to take on the ownership to say like, hey like this payor enrollment that we requested had four locations. You only sent us three, like please make sure the other locations included. So we’re going to do all of that as we kind of represent par status and all of that’s going to be notated in each of these individual lines. And so Latisha, what we’re seeing here is like this would just be all of northstar’s enrollments for example. But what we’re going to have, civie would have their own instance. And within that instance, you’d have some even higher level reporting that’s really going to aggregate across all of your partners. And so that would be, you know, a source of information for you as well. But great question. And we’re going to spend some more time here. So, but I will pause quickly. Like any more questions on just kind of like the basic data structure, how we’re organizing this data? And just kind of that single pane of glass view that we’re giving to you is like this overall provider data management solution. Okay. Cool. So northstar has added a new radiologist. Well, you would all get notified of that or we can certainly, you know, start like we could do some API connections to automate some of this. But for right now, we’ll just kind of look at that manual process. You would enter their email, first name, last name, start date, profession click invite member from here, they are going to receive a welcome email. We can have this with your logo or we could have this with northstar’s logo, whatever really is going to, you know?
Leticia Stewart (25:43) Really?
Samantha Bouchard (25:43) Relate to the client that they kind of understand their responsibilities and next steps, we would customize this language to your onboarding language that you have today. And then they would be brought through a customized onboarding flow here. And so this is where they can kickstart their profile through our proprietary integration with caqh. This can also be done from the administrator standpoint. So if you wanted to take a white glove approach and link their profile for them, that’s very simple to do as well. So I always like to call that out. And it sounds like you all are very hands on with your providers today, but we do make it as simple as possible for the provider to also do this. And so they can add in their caqh id, their social security number, and their last name. So we just need three pieces of information and we’re able to connect to their caqh profile and import up to 70 to 80 percent of the data that’s needed. So I’ll pause here. I know we talked a little bit about caqh about the management piece. It sounded like you all have access to caqh ids. Is this something that you think would be like a meaningful improvement to how you’re getting data from providers today?
Marie Ferailleur (27:14) I think it would. But my question, this will link it to caqh. Will it allow us to complete attestations, or that’s a totally separate process? Like any updates to caqh, can it be done directly from our end or must we continue to log into caqh? Yeah?
Samantha Bouchard (27:34) That’s a great question. So for this, it’s going to pull in directly from our connection with them. But what we do have is an additional offering which we call caqh management. And what that does is it allows because our connection with caqh is bi directional, we can pull all that information to kickstart the profile. But then you can make medallion your single source of truth. So any change, say they change their address, they add a new practice location, whatever it may be. You make that change in medallion. And we’re going to push that to caqh to make sure it’s accurate. And then we’re also going to take care of those quarterly attestations on your behalf. So, I know one of the examples that we talked about last week was, you know, 84 providers had to have their Coi updated. And so you’re going into caqh updating the Coi into 84 different accounts. And then shortly thereafter, you know, their attestations are due. And so that’s kind of another manual effort that really like impedes your day to day workflow with medallion. We can bulk load the Coi information into their profiles. And then with that caqh management, we would push that updated Coi into caqh for you all… Marie, from a time saving perspective, you know, based on what I just went over, would you be able to quantify like the time savings that would give you all?
Marie Ferailleur (29:15) Absolutely. Yeah. I mean, I was.
Josh Brunell (29:21) going to say I was just going to say I was talking to a customer this morning and they said they probably spend between 15 or 20 minutes handling the attestations and caqh updates per provider on a quarterly basis. And so, yeah, that might not seem like a lot. But when you have a 1,000 providers, like in your situation, correct? Or?
Samantha Bouchard (29:39) 84 at one time. Yeah.
Josh Brunell (29:42) Like that’s a lot of work for someone to deal with.
Marie Ferailleur (29:47) Absolutely.
Samantha Bouchard (29:50) Awesome. So what I’m showing you here is the provider’s portal. So the provider has access to their portal. Any tasks that are needed for them would display here. They have visibility into their profile. So they, if you all need an external account, they can come here and add it and it’s safely stored. If they need to add, say we’re missing their diploma. For some reason, we make it really easy for them to upload additional documentation. So rather than this going back in email, you all downloading it, uploading it where it needs to be attaching it to the payr enrollment application, they can take a picture with their phone of this QR Code, take a picture of their diploma that’s on the wall behind them. It’s going to instantly come into the system. And then we’re going to layer on OCR technology. So if you all have ever used like turbotax and like uploaded your WWW, and everything goes nicely where it needs to be that’s the technology that we utilize here for document uploads resumes to kind of just take off that additional repetition of then having to enter the data somewhere else. So a couple of ways that we just really make this simple. Sorry, Marie, was that from you? You?
Leticia Stewart (31:16) Took a breath. I thought you were done. So if the credentialing person needed to do all these things that you’re saying, like when you say go into caqh and upload the diploma, like if we’re doing all of this because I’m concerned that the doctor will have another platform that they need to sign into, and that seems to not go over well with anybody with doctors having to sign into another application. So everything you’re talking about could be done by our team?
Marie Ferailleur (31:53) Yes. Okay.
Josh Brunell (31:56) Yeah. There’s both options available if you want the provider uploading the info directly. If they’re tech savvy, and they can, you know, they would essentially just get an email notifying them like, hey, you have an outstanding task with medallion. They can either go to the platform and upload it or if you prefer to take the white glove approach and have your administrators do that, they can do that as well and just coordinate with the provider, whatever info is needed. We.
Marie Ferailleur (32:24) Have a it’s mainly, I don’t think it’s ever really going to be the provider, but they do have an administrator that does send these things to us by email. So, I think for them even to sit there and save it into a whole like a combined PDF. And this may be for the administrator, Leticia easier than bulking everything into an email, sending it encrypted, then we’ve got to, you know, decode it and get into that email. So the administrator let’s say, Brenda Jolin, she can go in, upload all of that stuff instead of emailing it to us. And then on the back end, other things, we can go ahead and continue with the white glove approach on our end.
Leticia Stewart (33:07) Right. And, you know, some of our clients don’t have that practice administrator or that front desk person or whatever. So, I’m just trying to make sure we have options like I want to make sure that whatever option works for every client we have that available, right?
Samantha Bouchard (33:23) Yeah. So you’d be able to set that on in an instance by instance. So instance equals client, a client by client basis. So if you want no provider enrollment for a specific client, we can turn that off for that particular client. If you want an administrator from the client to have login, there’s unlimited access from an administrative perspective. So they can have access as well. And we can support like some of the training efforts. And then, you know, if there is a scenario where you do want providers to be tasks that can be turned on as well. And what I’m showing here is just the mobile view. We do require a couple signatures from the providers to just attest to the information in their profile. But again like that’s all kind of done, you know, through technology, the simple finger scan and we’re able to capture that. And so I’ll go back quickly and we’ll just look at the provider profile here just from your view because I think I just kind of heard a few things that I think you all would find valuable. So one, you have a very similar view, just are going to have access to more information. You’re going to have access to all of their licenses, existing licenses, you’re going to be able to see what practices they roll up to you’re. Going to have another filtered view kind of down to any enrollments that are in flight, any enrollments that they already have as well. So all this data we’re essentially just kind of slicing and dicing it into a few different views. And then you all get to decide like what view is the most helpful for you? So I want to make sure we have time to just talk about payer enrollment since that’s another really big piece here. How does everybody feel about the onboarding process? How we’re kind of reducing the overall time to collect provider data. One thing I didn’t mention is I, know, you all have said it can take a week for an ideal provider, two weeks and beyond just depending on how long it takes to get all this information with all of the… technology and the integrations that I’ve highlighted here today, we find that providers complete their profile and we have everything we need in on average two days. So we are drastically reducing the amount of time that it takes to collect all of this data, which ultimately means the faster we have the data, the quicker we can get those payer enrollment applications out the door. And then obviously faster we do that. The faster par status comes in. Your clients are happy providers are billable and that revenue is accelerated. So I’ll pause any other questions about the provider profile would love any other thoughts or feedback that you all have on the process before moving into payer enrollment?
Leticia Stewart (36:39) You mentioned that you guys do the enrollment piece. So after all the provider information is uploaded, you start doing the enrollment request and that is part of your service or is that an additional cost that is optional?
Josh Brunell (36:58) So it is an end to end solution. So as far as the payer enrollments go, it’s an included piece of it. Now, if you decide to just use us for payer enrollment and not privileging or vice versa, you do have that option. But I think in your case, we’ll obviously walk you through what payer enrollment looks like in the process to get your feedback to make sure, hey, is this a good fit? But I think it would add value and Sam will kind of walk through how Leticia, but I mean, some customers use us just for credentialing just for payer enrollment or both. It really depends, think of it as this. You’ll have essentially a subscription. It’s a subscription model for the software. And then you can choose the different products or SKUs if you will on the left of what you want us to do and it’s just based off of units of work. So it’s like, hey, I need medallion to go out and submit a payer enrollment application or generate a cred packet or secure my provider a license. Those are different requests and that’s essentially how our pricing as models is just based off of those number of requests.
Samantha Bouchard (38:19) Okay… awesome. So what I want to show you in our payer enrollment module is one, how we store all of our payer enrollment requirements across, you know, 900 payers in the country and how we programmatically surface those requirements seamlessly to make sure that we capture everything needed for a provider application. I want to show you how simple it is to request a payer enrollment through medallion and then ultimately the visibility that we give your team each step of the way. So when you work with medallion, it’s not like sending a request into a black box and then you’re like twiddling your thumbs, like when are we going to get this back? We’re going to give you visibility each step of the way for you to kind of keep a pulse on how things are going and we’re going to use our automation and AI and workflow automation to really orchestrate this whole process. So.
Leticia Stewart (39:21) First,
Samantha Bouchard (39:22) I’ll just kind of highlight. You know, one thing that jumped out to me is that you all are, you are all surfacing, you know, kind of storing your own payor, enrollment requirements today. This is like a peek behind the hood. Hold on. Oh, I’m in my demo environment, so it’s a little bit slow.
Samantha Bouchard (39:56) Sorry, one second.
Samantha Bouchard (40:02) That’s like an administrative view. So sometimes it can be a little bit tricky. Hold on. Let me pull that back up. Sorry about that. But essentially what we’re doing is we are going to store every single payor requirement. So rather than, you know, Melissa storing her own requirements and other team members storing theirs, we’re going to have that stored for you. So as you expand into new partners, you’re not going to have to go out and search for, okay, what’s blue cross blue shield of Arizona’s, process, what’s the medicare process? All of that research is going to be housed and stored in medallion. We have a whole payor research team that maintains our documentation. And then we build that into our technology. And so the reason for that is when you come into our system and submit, you know, 10 payor enrollments at the same time, some of those requirements as you all know may be… like the same, right? And so you might come to blue cross of Arizona and need a specific document. And then by the time you get to cigna, you need that same document, we’re going to surface all of that directly and instantaneously. So let me, I’m back where I was sorry about that just had to restart. And now I’m sharing. So essentially for the, you know, the guide, we’re going to have all of the information that’s required. So is it a two step process? What documents are required? All of that information? And so your team is going to own the strategy and medallion’s going to own the execution. So you’re going to come in and say, okay, I need to enroll this new radiologist, dr Ely as part of the Plano group for north star. We’re going to surface the groups that are already available because that’s stored in our system. You’re going to select the state we’re going to tell you where she’s licensed. So you don’t have any issues with that. And then we’re also going to surface all of the group contracts that are already associated with that tin. So with the click of a button, you’re able to say, I want to enroll dr Ely in all 10 of the Plano group’s… contracts. You’re going to select this, you can add any additional payers, we’ll take you through a couple different screens that are associating those practice locations, Leticia, which I know are really important. And then once you hit submit that’s where your work ends and medallion really takes over. So we’re going to show you where that task is if it’s. Processing with the payer, if it’s complete, if there’s an additional task that might be needed to get that enrollment out the door. And we’re also going to use our technology here. So if there’s a portal submission, we have RPA technology that’s really going to come into play here and pre populate the portals… instantaneously. So you can see quickly this is blue cross of Arizona how quickly our technology is able to populate this portal, which today you all are entering manually, correct?
Samantha Bouchard (43:59) Yes, all that information is entered manually. Yeah. And so with the manual entry, right? Melissa, there’s always room for errors, right? You’re doing this day in and day out with our system. We’re going to reduce those errors. We’re also going to instantaneously check with our caqh management that everything in caqh matches what’s on the enrollment application. So we’re avoiding like an instant denial if for some reason some of that information doesn’t match. And then we’re going to follow these applications through all the way to par status. So we have a couple different ways that we’re able to do par status. We might do a portal scraper, like you can see here for medicaid or medicare. We’ll have AI emails that go out, AI phone calls, manual phone calls. We’re going to call each of the payers, so that as soon as that par status is available, your team is aware of it. So that’s going to be updated here. You’re going to have an active notification via email as soon as par status is achieved. And then we’ll attach the, if there’s a portal confirmation or an email confirmation of that par status, we’re going to attach it directly to this line. So if anything does come up in the future like Leticia, you mentioned if the location isn’t attached, but it should have been all of that’s going to be directly on that line. So you can come here and say, hey, medallion this was enrolled for, but we’re having billing issues, and then medallion will kind of take it from there. So I talked a lot, just want to pause for a second, see if you all have any questions about, you know, how we’re speeding up this process, how we’re using our AI and automation to get this out the door quicker. And then the visibility that we’re giving you all any questions or thoughts, anything that you liked about the process we’d love to hear from you?
Samantha Bouchard (46:09) Marie, I see you’re off mute. I don’t know if I can call on you? Oh.
Marie Ferailleur (46:18) Sorry, I was off mute here but muted on my keyboard. Sorry. Well, you won me on the time saving aspect of this app. I love it. I know that I need Melissa to give her feedback and I don’t know is Lisa’s voice. She’s sending messages in the chat?
Samantha Bouchard (46:43) Yeah, I just saw them.
Marie Ferailleur (46:46) Okay. So… my one concern there was a part, I know that it mentioned medallion, right? I know this is let’s say the software that we would be using, but can we, if we’re sending communication to our partners, can we highlight civie? Because this is, you know, the service that we are providing is all civie. It’s all, you know?
Josh Brunell (47:18) Yes, you could do your branding and then that welcome email that is sent out originally like that can get changed, all the texts in that can get changed to whatever you want in that kind of welcome email. And then we could also change some of the wording during the onboarding process like the pop up screen, the pop up screens that will direct them to the platform. So, yeah, no worries there. Yeah, I did see the chat regarding the privileging ask as well. Let me see.
Leticia Stewart (47:51) Yeah, we.
Samantha Bouchard (47:52) Do offer Lisa. We do have privileging for hospital applications. We have the joint commission credentialing, I’m guessing you guys are doing more of the hospital applications today. So that’s kind of tucked here in this privileging section. So I don’t think we’ll have time to cover it today, but would love to show you that and get your feedback on that as well. I think that just the last thing I’ll just leave us with on the payer enrollment is the revalidation piece. We know that could be really tricky. You know, you never want a provider to come out of revalidation out of par status after you’ve done this work. So all the revalidation dates are going to be stored here and then we can auto request or you have the ability to request a revalidation directly in the system. We also offer bulk demographic updates as well. And then we can support the facilitation of group enrollments. I’m not sure if that would be applicable to your partners, but I just wanted to throw that out there that we can support, you know, working with the payers to get the boilerplate contracts for a new group enrollment as well.
Leticia Stewart (49:08) Can you do that drop down again? Yeah. So when you do the bulk demographic update, like right now, I currently have an issue where apparently our… the lockbox didn’t get added to the provider. I guess it’s his, you know, location address, and we need to update that for all our payers. So that’s what this is. Yeah. Spot.
Samantha Bouchard (49:33) On Leticia. Yeah. So you’d be able to come in, select the group and then you’d be able to request, select the changes that you’re looking to make for the bulk demographic update and select the enrollments you want that to apply to. Can you?
Leticia Stewart (49:48) Just not select it here because you don’t have any data in here. Is that why it’s not actually clicking?
Samantha Bouchard (49:54) So what needs to be updated? You can add practice locations, and then you can move through and then you can select, you know, the payers that are associated.
Leticia Stewart (50:06) It’s really the billing address that needs to be updated, not the location address.
Samantha Bouchard (50:15) So that one we definitely can do. So part of your relationship with medallion is you would be, you would get an engagement manager and they’re essentially your like day to day operational contract. They all have payer enrollment, credentialing licensing backgrounds. And so if it’s something like unique like that, maybe we just don’t have, you know, why this might be because it’s a group. Let me see if there’s just other options here. Yeah. So we might just be able to facilitate like a custom request in that case as well through your through.
Josh Brunell (50:53) Your engagement.
Samantha Bouchard (50:54) Manager isn’t that?
Leticia Stewart (50:57) Kind of a common thing though to update, the pay to address?
Samantha Bouchard (51:03) Yeah, I would think so. Let me take that one back and just dig into that a little bit more with our operations team because I would expect that to be an option here. Yeah.
Leticia Stewart (51:14) Because I would want that to go to all the payers, like right now, we have to reach out to them one by one. I mean, we do it in a bulk setting, but it’s still us reaching out and then making sure that they responded. So I would want to know, hey, who responded, who made that change? How do I know they made the change? That kind of thing?
Samantha Bouchard (51:33) Yeah. Let me take that back and get you some more detail.
Leticia Stewart (51:36) Yeah. Go ahead. Sorry, I.
Josh Brunell (51:40) was just going to say like that… and the hospital applications piece, like happy to come back if you all are interested and continue the conversation to review those in detail. I also saw Caleb join. I don’t know if Caleb also was what team he’s on or if there’s anything that.
Leticia Stewart (52:05) He wanted, I wanted Caleb to join because when you started talking about payer enrollments, I wanted him to see that piece, but we kind of missed it, so sorry.
Josh Brunell (52:14) I could send a recap and I also have some videos I could send as well on the process.
Leticia Stewart (52:21) Yeah, that’d be great.
Josh Brunell (52:23) Short little clips of the platform. Yeah.
Leticia Stewart (52:26) So, I didn’t know we were going to talk about enrollment piece.
Samantha Bouchard (52:31) And.
Leticia Stewart (52:31) so he currently handles that. And so I’m sure that’ll be something he’d love to get off his plate. So I wanted him to be able to see it on that screen you were showing Samantha. It had like the revalidation date. And then next to, it had an end date. I didn’t understand… that.
Samantha Bouchard (52:53) I think is just a customized field. So it’s not something that you would have to necessarily use. And then all of our like the, I can just share again quickly. But all of these views Leticia like you can kind of like remove columns that don’t necessarily apply to you all. But if say you did request maybe somebody to become non par at a future date, if they were like leaving your practice, you know, you could enter that date there and know that you don’t necessarily need to do a revalidation for that provider.
Leticia Stewart (53:28) Oh, okay. Got it. Thank you. Yeah.
Samantha Bouchard (53:33) So, I mean, I think to josh’s point, I think Lisa’s really interested in the privileging piece. We could certainly circle back on some of the payer enrollment. And then one thing we really didn’t spend a lot of time on is just like the high level analytics piece, which I think you all would find interesting as well. So if the team would like, we can certainly, you know, set up another 45 minutes to dig into those pieces. What are the thoughts there?
Leticia Stewart (54:01) So on the facility piece, is that it, I don’t know if it sounded more like an afterthought because Lisa asked for it and we didn’t mention it before or is that really one of your core services where you have a lot of experience with that, that’s.
Samantha Bouchard (54:17) yeah. No, it’s our core service. When we talked last week, I think you all mentioned Lisa and that the hospital applications were kind of like handled by another department. And so we weren’t sure that she was going to join to incorporate it in today. And typically we wouldn’t have time honestly, Leticia to like go through that as well. But I, you know, it’s a very similar flow to what we showed for payor enrollment where your team kind of makes a request. And then we’re supporting a lot of like the custom applications, you know, any task management that’s needed as far as like additional documentation that Lisa’s collecting. And then the line by line tracking of like each of those hospital applications, like when they were sent follow ups lists of all your partners, things like that. So, yes, we have a multitude of clients that are using our hospital applications. And then we also offer joint commission credentialing for like hospital systems that are actually receiving the hospital applications and then running the joint commission file to kind of grant those privileges. So we offer both services.
Leticia Stewart (55:28) Okay. And the only reason why I’m asking is we’re kind of on a tighter deadline and I don’t want to set up another call for a week from now. I was going to bring that up too. I don’t want to wait another week to, you know, get a contract and then another two weeks to review the contract. Like I don’t have that kind of timeline. And so that’s the only reason why I’m asking. So basically what I’m asking is, can you, josh, you mentioned sending some videos, some documentation, you know, follow up and then whoever’s supposed to send the contract, can you just send me that as well? And we’ll start reviewing that while we set up that meeting so that we’re not pushing things out so far? Yeah?
Josh Brunell (56:07) I’ll this is actually thank you for bringing this up, Leticia. I will send… kind of like a questionnaire which will help me populate the proposal, the contract essentially for you. If that’s okay. I have a couple more questions for a scoping standpoint just to understand what you’ll need and what we’ll want to include. So I’ll follow up with that. I’ll follow up with the videos that were requested. Timeline. It sounds like it’s tight, like can you share? Like, are we thinking like you’re looking to make some decisions yesterday? Okay?
Samantha Bouchard (56:44) Yeah.
Leticia Stewart (56:44) We actually already have the proposal from modio to add the additional piece we’re already in. We already have modio and it’s for the facility side and we need to add the payer side and they’re waiting for a response. And I actually told them I will let them know last week, got it maybe this week. So I just need to let them know which way we’re going. So I need to see the proposal so I can make a decision or we can make a decision. Melissa, Marie, Lisa, Caleb, everybody on, you know, next steps and how we’re going to move forward. So I want to be able to see the proposal because say, for instance, you guys charge 300,000 dollars a month, then maybe that makes my decision for me. You know, I just need to know kind of, where we are.
Josh Brunell (57:30) Yep. I’ll send you this questionnaire in the next. I have a meeting starting in two minutes after that meeting ends. I’ll send you this questionnaire where it’ll give me all the data points. I need to put together the pricing proposal. And then I can, you know, meet as soon as tomorrow to review that with you. And… one other piece that I just wanted to share is like, yes, I’ll get the videos over. We’re happy to, you know, connect as well. It should honestly only take like 15, 20 minutes. So I’ll send some availability for tomorrow as well. I know Sam’s on back to back for the rest of the day as well, but I’ll send some availability if we wanted to sync on the hospital outside with Lisa just to make sure like it checks your box before we proceed, continuing the contracts discussions. Yeah.
Leticia Stewart (58:19) Definitely. And feel free to set that up with Lisa if you know, if I’m not available or Marie, Melissa’s not available, definitely… coordinate with Lisa because I think it’s pretty specific but I mean, obviously try to get us, but if we can’t I want you to proceed with that piece. So we don’t slow anything down sounds.
Josh Brunell (58:41) Good. So I’ll get that out to you. If we could get the response on your side as far as like just a couple questions like from the, as far as the pieces of data we need for the proposal, I could spin that back around within 24 hours and then we could connect to review it. I’ll do that. Appreciate. Thanks for letting me know about the timeline. Yes, happy to, you know, partner with you. I guess overall, it seems like there is good feedback and alignment and so appreciate the team investment in this so far. We’ll we’ll get started on that, and then Leticia is there a time tomorrow like a 30 minute window that would work maybe in the afternoon to review the proposal?
Leticia Stewart (59:27) I don’t know what that meeting is for. I’m double booked at nine that’s great 10. Okay. So any time between 11… and 12 Pacific Standard Time tomorrow?
Josh Brunell (59:45) Okay. Let’s do 11 30?
Leticia Stewart (59:48) Okay. Sounds good. Cool. I’ll get that.
Josh Brunell (59:51) Questionnaire over as long as, yeah, if we can just get those questions responded, most of the data I already got from your team as far as like number of providers et cetera. So it should just be like quick response there. And then I’ll have the proposal ready by 11 30 tomorrow. Well, the.
Leticia Stewart (60:09) Number of providers, I don’t think any of that included Lisa’s stuff when we were doing that. So I don’t know anything.
Josh Brunell (60:16) Yeah, that was going to be the questions I was going to ask around the hospital apps piece. So I’ll follow up with the group just on the pieces of data that we’re missing for the proposal and then we’ll fill in the gaps.
Leticia Stewart (60:29) Okay. Sounds good. Thank you.
Josh Brunell (60:32) All so much appreciate it. We’ll talk tomorrow. Bye. Everybody. Bye guys. Okay. Have a great day.