Transcript
Mishelle Cates (00:01) hi.
Nicolle Hepp (00:01) Michelle, how are you? I?
Mishelle Cates (00:03) Am good. How are you? I’m.
Nicolle Hepp (00:05) great. Nice to meet you.
Mishelle Cates (00:07) Nice to meet you.
Nicolle Hepp (00:09) Now, where are you calling from today?
Mishelle Cates (00:11) Washington state, cardiac study center. How about you?
Nicolle Hepp (00:16) Wonderful. We’re a remote company. So, I’m based out of Dallas Texas.
Mishelle Cates (00:20) Gotcha. Okay. Yeah.
Nicolle Hepp (00:23) Great. Well, my name is Nicole malkery, I’m on the partnerships development team here at medallion. We did get your website inquiry to learn a bit more about our solutions. So happy we could jump on for a quick 15 minutes here today, right? Really just wanted to sync with you, hear what you guys are looking for? I’ll be able to share a bit more about what we do and if there is alignment, then I’ll set you up on a deeper dive discovery for an additional 30 minutes with an executive at medallion later date. And, you know, if not no worries at all, it won’t take too much time today yep.
Mishelle Cates (00:58) That’s perfect. I don’t know what I’m doing yet. So, here we go. Wonderful.
Nicolle Hepp (01:04) Well, yeah, if Michelle, if you wouldn’t mind just telling me a bit about your organization, your role, you know, what brought to the website, and then we can go from there, yes.
Mishelle Cates (01:16) And hold on, I’m looking for your website again. Where is it?
Nicolle Hepp (01:22) Medallion co, how?
Mishelle Cates (01:25) Do you spell that? I’m apparently spelling it wrong? M?
Nicolle Hepp (01:29) ED a LLI o N.
Mishelle Cates (01:40) Okay. I just want to have this visually in front of me to kind of help me walk through things. All right. So we are a wholly owned physician… ambulatory practice. So there’s 20 21 owners currently expecting to be more, but I think we’re gonna have probably 50 providers or so. And this and this is, you know, highly confidential of course. So the situation we’re in right now is we are aligned with a local hospital system and this alignment may be coming to a, an end. And so we previously were just a physician practice and for cardiologists and everything that’s in cardiology. And so we’re looking at what it would take to become our own physician practice again, which means we need to get all of our doctors credentialed with all of the local hospital systems, along with all of the insurance payers and that’s where we sit. So we are preparing for this. We’re not sure if it’s going to happen yet. We really don’t know that’s why it’s highly confidential, but that’s potentially if this happens, I need to be ready to push the button and start this credentialing process immediately as soon as I know and get moving in that direction so our doctors can continue to practice and see their patients and have as little of a gap in the income as possible. Absolutely. And I’m the director of finance for cardiac study center, which is the company that I work for. Okay?
Nicolle Hepp (03:25) Yeah, makes sense. So right now, the hospital system handles all credentialing and payer enrollment. So this would be a new process for you guys, it?
Mishelle Cates (03:35) Would be for me. Now, they were that prior to the affiliation with the hospital group, and so, but I wasn’t here at that time. I’ve only been here about five years and that happened about 10 years ago. So I am brand new at this kind of stuff. I do have some experienced team members though hope, I mean, that are going to be helping me along. Thank God. Okay?
Nicolle Hepp (03:57) Yes, it can be. Yeah, quite an extensive process to credential and, you know, fill out all the payer enrollment applications for sure. So, yeah. Yep. Good idea to start looking at solutions, to help out. Yep. So you mentioned 21 providers right now, it could be looking to move into 50 I.
Mishelle Cates (04:20) Think so, yeah, by.
Nicolle Hepp (04:21) The end of the year. Okay. And then, do you know about how many payers you guys would be looking to get established with or, you know, how many they are currently with that you would need to roll over?
Mishelle Cates (04:34) Probably, I would say at least 25, probably more, you know, all the major ones of course. And then we being located in the pacific northwest, I’m sure there’s some niche ones out here as well. So we would be looking for those also. So I would say at least 25 actually more yep.
Nicolle Hepp (04:55) And it’s all in Washington. Is that correct? Our?
Mishelle Cates (04:59) Practice is in Washington. One facility in Oregon and one in Idaho.
Nicolle Hepp (05:06) Currently? Okay. Gotcha. Three states.
Mishelle Cates (05:08) Three states.
Nicolle Hepp (05:10) Yep. And it sounds like you’re looking to expand the provider count. Are you guys looking to expand like locations as well or states, what else? Well?
Mishelle Cates (05:22) We, we have 20 locations. So I don’t know that, that’ll be that’ll come in the future, but I think on the horizon, it’ll be just stabilizing the business and the locations that we already have.
Mishelle Cates (05:34) I think that would be our first priority because this is going to be, I mean, this could potentially be a very big deal if this happens so.
Nicolle Hepp (05:42) Right. Yeah. Do you know when you’re going to find out definitely if this is the case or not?
Mishelle Cates (05:51) I should find out within a month or so.
Nicolle Hepp (05:54) Okay. So within a month, you should know if this is a project worth pursuing or not. Yes, absolutely. And I can share a bit about medallion. Please, just because you are at the introductory phase of all of this. So historically credentialing has been managed with internal teams. You know, it would be such that you would stand up a few people internally. You guys might be using spreadsheets or even partnered with some sort of self service software to help manage the day to day. But the bulk of these processes has been historically manual. So you’re having to individually fill out these payer enrollment applications. It can take, you know, up to a day just to get one out the door to a payer. And then there’s a lot of follow up involved. And this leads to really long turnaround times. We typically hear anywhere from like 60 to 120 days, right? So your providers are waiting in the wings and they’re waiting to be billable for the business. So it can be pretty inefficient. The difference with medallion is over the past five, six years, we’ve really tried to automate as much of this process as possible and we offload the process for our partners. So, whereas you would have your team doing a lot of that manual work, our software automates about 80 percent of the workflows.
Nicolle Hepp (07:20) So things like producing a credentialing file in under three days is our turnaround time and then submitting those payer enrollment applications within 10 days and then owning all of the payer follow up as well. So what this results in is really shrinking those turnaround times by about 30 to 45 days and doing it at a much cheaper cost for the business. But I always like to make the differentiator that we are not just a self service software, meaning, you know, we sell the software to you guys, you manage it internally. It really is a partnership where you guys direct us. Hey, you know, you have a new provider joining, they need to be enrolled with these certain payers, submit that task to medallion. And then we have our own internal operational teams that can finish out that workflow of any human element involved that the software can’t fully automate? So we are an end to end solution. So, is that that’s what you’re looking for? Or did you guys, are you looking for more of building on your own?
Mishelle Cates (08:30) No, we don’t have our own at this point and I don’t foresee putting together our own in, you know, a month that doesn’t make any sense at all even by the time because by the time we know we need to do it, we’re behind the eight ball. So I need an end to end solution.
Nicolle Hepp (08:48) Okay. Wonderful.
Mishelle Cates (08:51) Do you also, so I like I said, I’m just getting into this. So I know we do the payer credentialing, do you, also, I think we would be, I think of our size, we would be able to be recognized as a facility to get a facility license. Do you do that as well?
Nicolle Hepp (09:09) We do facility credentialing? As?
Mishelle Cates (09:10) Well, correct. Because I’ve heard that makes it easier when you have new doctors coming on board. Is that, is that true?
Nicolle Hepp (09:19) Yes. And you might be referring to delegated credentialing where you use rosters and then you have, as a provider joins, you just add them to the roster with the payer and then it’s a seamless experience.
Mishelle Cates (09:31) Okay.
Nicolle Hepp (09:32) It’s different for every payer. So that’s certainly something you could explore with the payers that you guys had existing contracts with and see if that would be an option for your group. Okay? Something that can be touched on at a later date. But yes, we do offer those services as well and professional help.
Mishelle Cates (09:49) All right. Yeah. Yep. That’s what I’m looking for.
Nicolle Hepp (09:53) Great. And just to confirm, so, I know the hospital was doing a lot of the credentialing work. Do the tax ids with the payers? Is that with you guys, or would this be you’re having to stand up new group contracts? Yep, new group? Okay?
Mishelle Cates (10:11) Yep. Because we are under the hospital at this point. So we would have to peel that apart and put everybody under our own fein which we were before the merger. It wasn’t a merger before the affiliation.
Nicolle Hepp (10:24) Yep. That’s what I suspected makes sense. So standing up completely new contracts. Yep. Yeah. I mean, you still want your providers to be providing care and reimbursable?
Mishelle Cates (10:38) So, yeah, we want to. Yeah, exactly. And we just, we want to close that gap as quickly as possible for patient care and for, you know, to be able to pay our employees?
Nicolle Hepp (10:49) Yes.
Mishelle Cates (10:50) That’s important. Yeah, so.
Nicolle Hepp (10:52) I think at this time, I think it would make sense if in a month, when you get that direction of are you guys going to have to stand up your own credentialing and enrollment services or not? If it is a, yes, we’d be happy to continue the conversation and I can get you on that 30 minute deeper dive. Okay? And then if it’s no, then I mean, I guess there wouldn’t be an opportunity here, but I think if we wait for that direction that.
Mishelle Cates (11:18) would be our best bet. I can’t do anything until, yeah, I just can’t do anything until then. If we started it now then it would mess up what they already have. So we just can’t do that, you know, right?
Nicolle Hepp (11:27) Yeah, yeah. Just happy to get you the information here today. Can you?
Mishelle Cates (11:30) Give me a ballpark of the costing for this, of how much it’s gonna cost me?
Nicolle Hepp (11:37) So it’s pretty different for each client. On the next call, we would get some inputs and more precise volume from you where then we could give you a ballpark of the pricing. But at this time, it’s just a bit too introductory, okay to get into that.
Mishelle Cates (11:57) Do you guys operate on like a monthly cost basis? Or is it a, each provider each application type of deal? Because that’s I talked to another company and that’s what theirs was. Theirs was, a, each application process was charged by the each. So.
Nicolle Hepp (12:11) Right. So we’re based on consumption. So that’s why it’s different for every partner. So things like per provider, per enrollment application, there’s a per provider seat pricing… you know, if you want ongoing monitoring that’s separate. So really there’s a laundry list of things that you guys can check off and you only pay for what you guys are using and it’s based on an annual basis. Oh, okay. So.
Mishelle Cates (12:42) I know you can’t give me an exact, but a practice of this size, let’s just say we stop at 50 and that’s what we have and we get facility as well. Are we talking hundreds of thousands per year? Are we talking a 30,000 cost per year? Do you have any idea you can give me? I’m not gonna hold your feet to the fire. I’m just trying to get my head around the cost of, this particular item have to build it into my new budget?
Nicolle Hepp (13:09) Yeah. I mean, what I can say is that there is a 50 K minimum per year, got it. That works. But I would expect you guys to be a little above that. If you do have, you know, 20 30 new providers coming on in a year, it would probably be higher.
Mishelle Cates (13:27) Yeah, perfect. That’s all I’m looking for that works for?
Nicolle Hepp (13:29) Me and that’s in line with your budget? Yeah.
Mishelle Cates (13:31) Yeah, just to get something in my head, is perfect. And yes, I will build this kind of thing into my budget. All right. And so what is, so yours is end to end? Do you know anything about gosh, who was the company I was talking to yesterday? Because theirs sounded like it was end to end, but like I said, it was piecemeal and now I can’t find resilient. Have you ever heard of that company?
Nicolle Hepp (13:55) Resilient? Yes… I don’t think, I know that one that’s not a big player if I haven’t heard of it because I’ve been in this business for almost two years now. So I don’t hear that one too often all.
Mishelle Cates (14:12) Right. Well, okay. Great. Because like I said, they were just giving us their prices were per each application per each process, whatever it was. So I don’t know how that fits in. But anyways, just wanted to ask if you knew anything.
Nicolle Hepp (14:28) All.
Mishelle Cates (14:28) right. Well, this sounds great. Thank you so much for your time today. At least I kind of I’m starting to get my head around this stuff. Yeah.
Nicolle Hepp (14:36) Absolutely glad I could help for next steps. Why don’t, I send you an email of a brief overview attachment just so you can have a little overview of what medallion is and how we can help. And then I’ll put a note. I’ll reach back out and let’s say, end of April would give us would put us at a month and we’ll see where you guys are at. And if it makes sense to get on another call that?
Mishelle Cates (14:59) Is absolutely perfect. That’s the timing that I need to go with. So, yes, that works for me sounds.
Nicolle Hepp (15:06) Great.
Mishelle Cates (15:07) And you’re so your turnaround? Okay. Yeah. So that’s it. So, I’ve been telling because our doctor’s been asking how long it’ll take to get this done and I’m telling them that… you know, we’ve been telling them like three to six months, but you can actually get that time reduced a little bit for getting contracts in after we get our, to get our credentialing done for at least the bulk of the doctors. Is that true?
Nicolle Hepp (15:35) I mean, there’s certainly an implementation timeline of a couple of months and then getting the group contracts takes time, but certainly medallion what?
Mishelle Cates (15:46) About like medicare, what about medicare and medicaid? Do you know how fast those go or?
Nicolle Hepp (15:50) Slow. So… those are pretty seamless, they have portals, but I don’t have those exact timelines for you and it varies by state, so.
Mishelle Cates (16:00) Certainly something.
Nicolle Hepp (16:02) That we can, we have a database that we could look up for you of where our averages are for each payer. So if that makes sense, we can get you those data points on a next call, yep would.
Mishelle Cates (16:14) you be able to get that for me in the thing that you’re sending over for at least medicare that’s you know, our biggest payer of course.
Nicolle Hepp (16:20) I don’t think I can do that at this time. That’s not.
Mishelle Cates (16:23) Under my.
Nicolle Hepp (16:25) scope, I’m sorry, but the executive I would connect you with would be able to get you that those inputs. Okay, great. Yeah.
Mishelle Cates (16:33) Well, thank you.
Nicolle Hepp (16:34) Great. Yeah. Any other questions or I will let you go and send you over that email?
Mishelle Cates (16:39) Yeah, sounds good. Sounds good. Thank you.
Nicolle Hepp (16:42) Great. Thanks so much, Michelle. Thanks for reaching out. Take care. We’ll be in touch.
Mishelle Cates (16:46) Bye. All right. Thank you.