Transcript
Mallory Smith (00:49) hello? Good morning.
Sonya Turner (00:50) Good morning.
Nicole Moody Luther (00:52) How are you? Good?
Mallory Smith (00:53) Morning, good.
Erica Lloyd (00:54) To see you both. Good to meet you.
Sonya Turner (00:57) You too. I’m.
Mallory Smith (00:59) trying to get.
Sonya Turner (01:01) my life straight here.
Nicole Moody Luther (01:02) I know trying to here here.
Mallory Smith (01:04) I mean,
Erica Lloyd (01:06) we’re a zoom shop. So I’m a little clunky with teams that’s okay. There you are. Can you hear me? Yes. Hi, mal. Oh, okay.
Mallory Smith (01:22) I was about to change it. Thanks, thanks for confirming, not the best, but we’re.
Sonya Turner (01:27) here we’re good now. All good, Joshua. Hi, good to see you, hi.
Josh Larkin (01:33) Good morning. Good to see you guys too. Sorry. I’m two minutes late.
Sonya Turner (01:37) All good.
Erica Lloyd (01:39) Is everyone on site? I see Tahira, you’re on site? Are you remote?
Nicole Moody Luther (01:45) I’m on site?
Erica Lloyd (01:48) Nice. Well, why don’t we just start with introductions, appreciate you all. Taking the time. I know rob connected us, so it means you’re all probably pretty close to how things work. So, why don’t we just start there. And also, I know Olivia set us for an hour, don’t think we’ll need the full time, but glad she gave us a little bit of buffer. So, my name is Erica Lloyd. I’m enterprise account executive here at medallion. I’m based in New Jersey, and I support customers throughout the use case of everything from the time they hire a provider, to licensing, credentialing privileging, and getting them to billable status… and I will kick it over to Mallory. And then I’ll popcorn over to your team. Thanks.
Mallory Smith (02:33) Erica, it’s a pleasure to meet everyone today. I am Mallory smith. I’m a solutions consultant based in Nashville, Tennessee. I’ve been with medallion for a number of years and I’ve been in the provider space for just under a decade, and I’m going to keep saying just under a decade until they make me change it. But it’s a pleasure to meet you all.
Erica Lloyd (02:55) Josh, you want to go first?
Josh Larkin (02:57) Sure. Good morning, everybody. I’m josh Larkin. I’m currently the manager of denials and underpayments. The reason why I’m on is I have a little more history than Nicole does in the payer credentialing realm here at centra, but that was one of the teams when I first became in leadership took over and we had currently at that time had it outsourced to athena health. And I was instrumental in bringing that back in house and creating that team, working with the payers and setting up delegated credentialing… and then also working very closely with the medical staff. So I have a little more of the history to bring to the group, but excited to hear from you guys today and see what you guys can offer.
Mallory Smith (03:43) And I’m good.
Nicole Moody Luther (03:45) Morning. And I’m Nicole moody, Luther, I’m the manager over credentialing and customer service. I’m newer to the play field when it comes to credentialing, but looking forward to hearing what you all.
Erica Lloyd (03:56) Have to.
Nicole Moody Luther (03:57) Offer this morning. And.
Sonya Turner (04:00) Lastly, I’m Sonya turner, I’m the senior director of patient financial services. So I oversee multiple areas including customer service, payor, credentialing, patient accounting education… and there’s some other things. But it’s too much to even think about at this moment. So, main pieces are payor credentialing that we’ll be talking about today. And very excited. I have overseen the payor credentialing department since josh overtook it, and that was whew, probably six.
Josh Larkin (04:35) Eight years ago.
Sonya Turner (04:36) Yeah, yeah. I was gonna say closer to 10. I’ve been here for 22 years at the organization. So have been through, have seen quite a bit here at centra. So can provide a good amount of history and like josh and Nicole said, very excited, just so you know, a little history as we have gone through the transition with our teams and kind of right sizing and making sure we have the right people in the right seat. Josh previously was over payment, posting refunds… and payer credentialing. And then we had a change in management for our acute patient accounting and he stepped in his interim and was doing both. And then there came a decision making time and he could either go back to his previous role or either stay managing the pay, the acute posting, acute patient accounting and posting. And he chose that. And so then with that payer credentialing transitioned under Nicole, but he’s still there helping with Nicole. With that. We did not make any formal changes in like our payco system and things like that. Because the idea before our VP left was to see if we could get credentialing transition under the managed care department because it fits so much closely with the contracting and works hand in hand with contracting. But then our VP left and so that didn’t happen before he left. And then rob sent me an email, josh and I an email about this connection and I said, yes, we absolutely want to talk to them, see what they have to offer, see if it’s you know, possibly a good fit because it is a lift and we don’t own the whole piece of the pie. There is a separate piece for the medical staff office and the clinical credentialing. And so that is where we are today.
Mallory Smith (06:46) Thank you for that. Wow, 22 years. I.
Sonya Turner (06:50) mean 22 on April the fifth, Nicole has been here for 22 years as well. No way. No, wow. Honestly, we know, we look like we just started like, you know, five years ago, you sure do. I was thinking.
Mallory Smith (07:06) Thirties, maybe.
Sonya Turner (07:07) I just… celebrated my 40 seventh birthday. Wait like.
Mallory Smith (07:18) Just celebrate. Are you a pisces? I.
Sonya Turner (07:20) am a pisces, February 20 first.
Mallory Smith (07:24) Mine was March sixteenth and I’m still celebrating girl?
Sonya Turner (07:27) Pisces pisces energy? Yes. So, yes. So, yeah, I, yeah, 47. So, wow.
Mallory Smith (07:35) Congrats for that. Congrats on the tenure that’s for all three of you. That’s awesome.
Sonya Turner (07:40) Yeah, cuz josh has been here 12. So, I mean, we’ve all stuck it out and there’s been a lot of changes and, yeah.
Mallory Smith (07:47) Worked together for a long time.
Sonya Turner (07:49) At this point, yeah, we’ve been together for, so, Nicole and I have been together probably for… I know, but don’t say it like that. But since 2011, no, 2012. Yeah. So 14 years, yeah. And then josh, for 12, okay?
Mallory Smith (08:14) So, what about covid? Did you, did you have to go in the office? Did you go remote? How was.
Sonya Turner (08:19) that all of our staff went fully remote at covid, which was quite interesting for us because everyone was reporting on site, and interestingly enough, at covid, we were one of the hospitals that were giving out vaccines very early and actually ran a vaccine center and I volunteered us.
Sonya Turner (08:51) So, I volunteered us to schedule all of the people that were coming in for vaccines. So we did that for three months and that was pure.
Mallory Smith (08:59) Chaos.
Sonya Turner (09:01) but pure chaos in a great way because I think it really showed individuals like we, I said they were doing it on a spreadsheet. Okay? So I was like you’re scheduling people and putting them on a spreadsheet. And so someone said, do you think you can do it better? And I’m like, I know I can do it better like what? So, yeah. So then I met with all of them and I said, so guys guess what and they’re like, here she goes. And it’s these two managers. And then one other manager and I said, well, we’re going to run the vaccine scheduling clinic and they were like, okay, when are we starting? And what are we doing? Do we have a place set up? So they set up a room for us. We were taking phone calls and we scheduled about what 30,000 people for covid shots in those three months. So it was, we broke the phone system at our main hospital for a day. Our new VP at the time, who just left, he had just started with the organization. He came down. He was answering phones with us in the trenches. But, it was a great opportunity to get to serve and to also show people that we can do things just off the fly within. I mean, I think we set it up within two days. And two days later, we were scheduling and getting people vaccines and it was nice to help the community in that way. And so we’re pretty much you give us something and yeah, we all kind of volunteer for stuff and know, hey, we’re either going to succeed or either we’re going to die trying. So I’ll.
Mallory Smith (10:48) tell you what if they don’t put you guys in the history books for single handedly stopping the covid like pandemic that we’re in, that is very notable, seriously, the fact that you’re gonna reach 30,000 people in three months. I can’t even think of how many patients per day that is. And then you have to let them sit there for 15 minutes to make sure they don’t have an allergic reaction.
Sonya Turner (11:06) You gotta have, the.
Mallory Smith (11:07) space to let all of that happen. Congratulations.
Sonya Turner (11:11) No wonder.
Mallory Smith (11:12) You’ve been there for so long, you clearly get things done.
Sonya Turner (11:15) We try, you know, we try and it’s you know, I think we’re we have all been here as long as we have because I think we all truly love what we do and the team that we have built. I think that we all work very well together. We know each other’s strengths, we know each other’s weaknesses. So I think that really helps a lot and knowing that it’s not necessarily all about the work it’s about the people for me and making sure that my people are good because if your people are good, then the productivity will come out of that and not so much focusing on the number but focusing on the people and then everything else kind of works itself out. And that’s just kind of how we lead. So I think.
Mallory Smith (12:02) it’s a perfect segue. So with your can do attitudes, Erica, if you want to kind of launch into credentialing, we might be able to help you out there too. And then that way you can also be in the history books again. It’ll just be you’ll be a regular.
Sonya Turner (12:16) We would love it.
Erica Lloyd (12:18) Well, I’ll be, I’ll take us back to I’ll, take us back into the less fun stuff. So I was thinking why don’t I just give you an overview of medallion credentialing services. And really at a really high level, I had a couple value hypotheses just from researching. There’s a lot going on at CMG right now. So why don’t I share, I could share that and really just to see if it makes sense to continue the conversations into potentially an evaluation, you know, understanding criteria aligning there and hoping that with my hypothesis, you all seem like you could fill in some blanks for us and see if we’re on the right path. Does that sound good?
Sonya Turner (12:58) It sounds great?
Erica Lloyd (13:00) So let me, I guess, let me just start give you a high level overview. Do you know, do any of you know anything about medallion? It’s okay. No, no, it’s okay. Also. Okay. So just at a high level, we are a managed service. We use AI. We use agentic AI and automation to complete a significant amount of the tasks within the provider credentialing space. And when I say credentialing, I’m talking about the entire process. So it sounds like it’s siloed, which it usually is in large health systems, but payer, enrollment, credentialing, delegated, you know, delegated roster generation, hospital applications and privileging, well, privileging in your case, since you’re in the health system licensing, ongoing monitoring and primary source verification.
Mallory Smith (13:50) And so the,
Erica Lloyd (13:52) reason that it’s kind of a value add with doing automation, is it’s going to reduce the cost, the errors, the denials, josh, that’s in your wheelhouse. And so we have the combination of both the hands on experts and sorry the automation and then hands on experts to oversee the parts that need human oversight for compliance reasons. And so with this whole kind of modernization process of software services automation, we can contractually commit to slas with pretty aggressive turnaround times which is helpful to have like a high watermark on what their turnaround times can be forecasting. Planning access is obviously, super important. And so it’s going to be outcomes are going to be reduced, opex, accelerated… revenue, improved margins, which is always really important and really just more.
Sonya Turner (14:48) Better.
Erica Lloyd (14:49) Provider experience also. And so let me just share a I’ll share a quick slide here. I’m curious.
Mallory Smith (14:58) I.
Erica Lloyd (15:00) practiced sharing on teams. Am I sharing this?
Mallory Smith (15:06) So this is actually a really cute story. So, Erica’s husband uses teams and she practiced with him using that teams to do this because we’re so zoom focused.
Sonya Turner (15:18) No worries. There’s no judgment on this side. It took us a minute to get used to teams. And now zoom, we’re like we can’t do zoom because zoom like, yeah, it doesn’t work well with, our Microsoft. It just, yeah, I don’t know like cats and dogs.
Erica Lloyd (15:36) What of these, what I know there’s this transformation project going on which we can kind of get a little more into. What of these are like top of mind for you?
Sonya Turner (15:48) Accelerate revenue, reduce operating the order that you have them in. So with our margins right now, they are very slim as you probably got a little bit from rob, maybe not. But with this transformation project, it is seeing how we can reduce costs but improve efficiency, improve efficiencies at the same time, prevent denials upstream because we know that there are a lot of denials that are preventable that we are seeing within the organization. Historically, like most organizations, patient accounting is kind of your dumping ground. We fix everything and then get the claim out and revenue in. But if we could reduce that, then that reduces costs in so many different ways, touch points and so definitely accelerating the revenue would be awesome to help that bottom line.
Sonya Turner (16:46) And then reducing costs with the ftes. Ftes is a hot topic right now within the organization and seeing where we can automate put in AI even within our patient accounting. We are looking at what things could we use AI to reduce a touch that a system could do? But then using our employees to work those harder denials that really require eyes. So kind of what you said, you know, using AI to do the simple tasks, but then having human oversight for some of those more in depth tasks. So it’s the same methodology that we’re going to be looking into very heavily in our patient accounting area. And then the provider productivity. I think that is something that operationally for CMG they have been working on for quite some time and trying to figure out how they keep those schedules full, how we hire a provider and get them started within a timely fashion. So that we’re not holding claims until they get an effective date because a lot of times they will give us an effective date that is not going to work with the time it takes to get the payer to get them credentialed and enrolled. So yeah, you’re.
Erica Lloyd (18:06) speaking our language, these are all the things.
Sonya Turner (18:10) So,
Erica Lloyd (18:11) I guess a few questions here. And honestly, it sounds like we’re timing is right with rob even just open having a conversation. Cfos usually have a 1,000,000 other things going on. So, I figured if he was like let’s have a meeting there’s. Probably something going on there. Okay? So thanks for sharing that. I think, you know, you kind of hit on all this a.
Sonya Turner (18:32) Lot you.
Erica Lloyd (18:33) Know funding shrinking… when you’re saying getting your… effective dates sooner, do you know today? So obviously one of the metrics that we really look to improve is obviously for your non delegated agreements, we can touch on the delegated agreements also because that’s important. But for non delegated, do you know what the turnaround time is to get your providers from?
Sonya Turner (19:01) The.
Erica Lloyd (19:02) time you make them an offer into the time that they’re effective?
Josh Larkin (19:08) So I can talk from the time of submission to the time of when we get that effective date. So that turnaround time for us is pretty high and it has been ever since covid, and it’s around right around 90, leaning more towards 120 days from the time of submission of that application to getting that effective date back. Okay?
Erica Lloyd (19:36) That’s typically, what we see is 90 to 120 for non delegated. Do you know of your commercial payers? Like what the mix is of delegated versus non delegated?
Erica Lloyd (19:51) Want.
Josh Larkin (19:52) to say we have six or seven delegated payers if I recall. And then on top of that, you know, we have our government payers which we know can’t be delegated. But, you know, we have slowly started to work on submitting medicare enrollments through Pecos, to find extra time there as well. Instead of doing paper applications. We have been trying to dabble a little bit there as well and getting those submitted through Pecos.
Sonya Turner (20:27) That’s helpful. And for our commercials, we only contract with about what? 10 to 12. So we’re delegated with seven. We’re probably about 70 percent. So those 10 to 12, you know, are your anthems, your unitas, your etnas, your maritain… what’s, cigna… anthem healthkeepers. And I’m probably missing a couple, but our commercial payers. Yeah, with all the major commercial payers, we are, we have contracts, some of the smaller ones we don’t have contracts with. But then we just went out of network with humana and medicare and humana, medicaid. We are no longer in network with them. That was an organizational decision because we were having quite the time getting them to pay our claims appropriately. So there was some back and forth there and the decision was made to go out of network with those two payers. But yeah. Okay. Well, that’s terrible. I’m sorry, humana is a, I don’t know how big of a market share it was for you guys specifically, but I’ve been hearing more and more of that in the industry. Yeah, it’s not a huge market share. So, we are very heavily. We’re about 63 to 65 percent medicare business in our area, which is higher than most areas. We have small. We have a more aging community that we serve. And so it’s about 63, 65 percent medicare. And then your commercials and your medicades make up the rest of that percentage. I would say our biggest commercial payer would be anthem with probably what united coming in second. And then the others trickling in after that.
Mallory Smith (22:42) Absolutely. I’ll withhold my jokes about medicare in Florida obviously, but I’ll be honest, I do plan on retiring to Florida when I get to that age. So I understand.
Sonya Turner (22:53) Okay.
Erica Lloyd (22:57) So, thank you for that. And they’re in Virginia. I thought you were in Florida?
Sonya Turner (23:05) No, rob lives in Florida and comes here once a week, but we are in Virginia maybe.
Mallory Smith (23:11) That’s what I was thinking. Oh, well, never mind. Well, now, you know, her retirement plans. So hit me up in 30 years.
Sonya Turner (23:20) Are you trying to go 30 more? I was like.
Erica Lloyd (23:23) She’s young. I was like, she’s 30 more years us with the four in front of our age, right?
Sonya Turner (23:30) That retirement is looking closer and closer. I.
Mallory Smith (23:34) Won’t say I’ll never be able to retire. Come on.
Erica Lloyd (23:37) I won’t say what for, but there’s a,
Sonya Turner (23:40) I’ll leave it there.
Erica Lloyd (23:43) Okay. So, I guess before I start solutioning 90 to 120 days, where do we think? Where is the hypothesis on where the bottlenecks are in? That 90 to 120? Because we, we’re typically medallion… is usually around 52 days for non delegated. And there’s a lot of we can show you in platform which I said, I wasn’t going to start solutioning but here I am… we’re so we’re typically about 52 days, with the automation, and different processes, we have what’s typically the biggest bottleneck you think that it’s taking that. And that’s typically what we see is 90 to 100 before pre medallion. So.
Josh Larkin (24:24) I’d say, and Nicole jump into here. I think we have two bottlenecks first is submitting that application and then having the payers send us notification that one they’ve received it, right? We, we have a hard time getting that acceptance back that they have the application. And then two it’s that follow up time, you know, that, yep, definitely that follow up of, okay. Do I follow up at 30 day? Do I follow up at 60? If it was somewhere in between, how did I, how could I do it sooner to catch the approval quicker? So I’d say those are definitely the two big areas at least from my perspective.
Sonya Turner (25:06) Absolutely two. It’s, a high management oversight area that you don’t have immediate Roi on if that makes sense. So from an fte standpoint, no one ever wants to give up ftes, right? Like because you’re talking about people and you’re talking about ftes, but if you’re speaking realistically from a leadership standpoint and a business standpoint, if there’s an area where it makes sense to outsource, and it makes sense to have someone who that is their main focus. And that is what they do day in, day out. And you can shrink the time that it takes to complete the task. This would be that area. And I think that, you know, 52 days it, I don’t know that manually we would ever get to 52 days just because of all of behind the scenes work of checking and rechecking, and we only have seven one two. We have seven, seven ftes. Well, six now, I’m sorry. Yeah. So, six ftes and that is with keeping up with making sure that their recredentialing is done, following up to make sure that their license doesn’t get expired like all of those tasks. So it’s not just one piece that they have to focus on. And then if there’s problems with the contracts, then they got to work with managed care. So, it’s one of those things that the Roi for really having it in house from a payer credentialing standpoint, you don’t really realize because of all of those pieces which I’m sure you’ve heard but, yeah, I.
Erica Lloyd (27:04) Will say we’re having conversations with several health systems in Virginia right now with the same type. We have one we’re having a conversation with has 11 ftes. Yeah. And it’s honestly just kind of tripped them up. And then, you know, we were thinking we were talking about this and… automation is going to do these tasks whether it’s done now or at some point in the next couple of years like it’s going to happen. It’s just a matter of when, where and how and who is doing it. You know, another one we worked on, it was more of like a behavioral health and substance abuse and they used us to, they only had to off, they only had to off board about two ftes but then not higher for additional growth. But really it was like, hey, denials are huge and that needs human oversight. Let’s not use ftes. That may that we can’t contractually commit to an outcome with an fte. It’s not high value work. It’s high turnover in some places and it’s just, it’s really difficult. So, yeah, I mean, so many applications and we can go into it in more depth but there is agentic ways, you know, agentic AI ways that we’re able to follow up to get to that fte. And again, we do contractually commit to outcomes. So that is going to help with planning and forecasting your business.
Sonya Turner (28:28) So,
Erica Lloyd (28:28) it sounds like obviously the application fund with the payers, things like that’s the biggest bottleneck, how about provider onboarding? Is there, is that some, any area to compress? Or do you feel like you’re pretty efficient there?
Sonya Turner (28:40) So, we provider onboarding in the sense of hiring, and those pieces do not fall under us that’s operational.
Sonya Turner (28:49) So we only get notified once the provider has been hired and they give a start date, and then that’s when our process kicks off. So that onboarding, is in the operational area for CMG?
Josh Larkin (29:05) Okay. Gotcha. And they pick, they’ve been able to not… stream. I streamlined, I guess the right word streamlined, their start date based upon us on the back end of that 90 to 120 days. So if we can shorten that, I’m sure they would love to have providers start quicker than that, but that is like kind of the average that they’ve we’ve had to drill into them. Hey, we need this allotted amount of time to reduce those write offs. So unfortunately, you’re going to have to wait three months before you get a provider in the door.
Erica Lloyd (29:45) That’s tough especially when there’s a provider shortage especially for advanced providers.
Sonya Turner (29:49) Absolutely. Yeah. Okay. So.
Erica Lloyd (29:52) Are you holding, are you having your providers sit on bench or are you and not see patients while you’re waiting for their effective date or are you having them see patients and then writing it off or trying to backdate?
Sonya Turner (30:05) I see smiles. So for payers, that will backdate and give us a previous date. So your medicare’s your tricare’s we say, yes, they can see them and then we’ll hold claims. And then once we get an effective date, then we get a script run by our it department and we submit the claims and we can get reimbursed for payers that do not backdate. We ask that they do not schedule the patients with those providers, but that typically doesn’t happen. And then hence come the write offs because they’re not credentialed.
Erica Lloyd (30:42) Okay.
Erica Lloyd (30:47) So, and I’m asking because that’s whenever you’re going to ask for something like if you want a champion medallion, you want to ask rob and, you know, other executive sponsors for funding to make this type of change. Obviously funding will typically come from fte reallocation or right? Sizing a team reallocation of different technology that you have today, but.
Sonya Turner (31:12) also these type.
Erica Lloyd (31:13) Of things, the write offs are huge. It’s like if we quantify the write offs, if we can impact those write offs by let’s say 50 percent. Obviously, we’re not going to say, yeah, well, you’ll never have a write off again if you work with medallion, but if we can move the needle and make it go from, you know, 2,000,000 in write offs or 4,000,000 in write offs and quantify that down by a few 1,000,000 fte reallocation, you know, there’s different ways that we can do an Roi multiplier. And typically to make an investment medallion, we’re seeing usually companies want to see a three to five X multiplier of Roi on the investment? And.
Sonya Turner (31:51) What would be, so, because we can get that data because we do adjust off based on specific aliases. What would be the time frame that you would want to see that data for totals for write offs? Is it 18 months, two years, three years?
Erica Lloyd (32:08) Mallory, I’m going to tag you in on that?
Mallory Smith (32:11) Yeah. So typically the past 12 months is accurate for what we need just to give you a better estimation, 18 months. I mean, the longer the.
Sonya Turner (32:20) better, of course.
Erica Lloyd (32:21) But I.
Mallory Smith (32:22) think if your 12 months is close enough to your percentage that you would normally see within 18 months, then that’s fine. Yeah.
Sonya Turner (32:29) So I will say that I probably will see if our, it can run 12 and then 24 because we did make some improvements over the past year. So I think to give you a better idea of where we came from 24 months ago to where we got it down within the past year. Then that may give you a better idea of where you think you could reduce even more just so that you can see what that has been because we have reduced some, but of course, we still have, you know, still have write offs, but I think having those two data points would probably help you make better estimates as to what you think is realistic because the improvements we made were improvements manually. I can only imagine what they would be once you’re using AI and looking at those tasks. So.
Mallory Smith (33:26) Absolutely. And I would add to that with the Roi and the business value assessment we’re able to do for you. With those data points. I think that’s a fantastic call out to go back 24 months, see the manual improvements and then how it affects it. We look at things such as the average revenue per provider per day. We look at self pay versus commercial, how many days we’re saving you on average per plan, multiply that by how much revenue you would normally see. Our onboarding timeline for instance, is two days on average because we have a caqh integration. So if you even see something from 15 days to have the providers onboarded, that’s an additional taking out the weekends that’s an additional, what eight or nine days of revenue that they can start seeing? I’m curious actually. So from an onboarding perspective, you get the provider onboarded, they send you all their information. You have the back and forth emails and calls and everything like that. Do you credential to ncqa standards? Do you credential to joint commission? Do you do that before or at the same time as you’re enrolling them in payers, if you do it at all?
Josh Larkin (34:33) So, it’s kind of collaboratively at the same time once we have all the documents. So typically the medical staff and the onboarding department have that interaction with the provider. We’re kind of behind the scenes because that was one of the pinpoints where the provider was getting confused between clinical and payer credentialing. And so we took ourselves out and allowed them to be the, and gather our items for us. So a lot of times, you know, they’re working with the provider up front at the very beginning but we can’t really submit anything till we have the license, the Dea, the certificate of insurance that’s issued and that sort of thing. And so that comes, you know, potentially maybe day 60 during their onboarding process. So, or, you know, 60 days from their start date because there’s some requirements there for their certificate of insurance of how quickly that can be issued to their start date. So those are some other things that kind of halt our process to begin if that helps. No.
Mallory Smith (35:43) It does thank you that’s also a great call out with the malpractice because typically it takes like seven to 10 days to get that back. But then it can’t be too far before the start date because that’s coverage for no reason. So completely hear you on that for the med staff.
Mallory Smith (35:59) Every time I hear them. I think joint commission is that what they’re doing? Currently? Yes. Okay. I’m kind of I’m doing the same thing Eric is doing where I want a solution just a little bit. I want to paint a picture and see if you think that your med staff team would ever be open to this. So when we worked with groups in the past where they needed to go to the med staff team first, they were very particular about their order and the processes and things. And then it was shared with the enrollment team, we have been able to work with them that you invite the provider to the medallion platform. And we actually have a five day SLA for joint commission files. So essentially you invite them, we connect their caqh without having to use the provider’s username and password. That takes two days on average. And then they request the joint commission file. We have that ready for them within five days. The key here for those groups that their med staff is very different than their enrollment and they don’t want to change that whatsoever. We understand everyone is able to see the information in the medallion platform. So your team would be able to see if you have the license, the Dea. You’re only waiting on malpractice as soon as it’s uploaded by the med staff team, you’ll be able to see in the provider’s profile. So that way people in particular, I get it they want to keep their team separate. They’re still able to do so in the medallion platform. So with that vision, do you think your med staff team would be open to that just considering the slas we have in the process and then sharing the information. It’s not just emailing it back and forth anymore.
Sonya Turner (37:32) Yeah. So I think… with rob driving and with the transformation that is occurring in centra, I think that anything is possible and anything is on the table?
Mallory Smith (37:46) I’d love to hear that. Okay, awesome. Well, we’ll keep the conversation focused on your team of course today, but I always try to think bigger picture. How can we make it smoother for that provider experience? And just to think that a provider could be onboarded joint commission ready within a week and then enrolled within 52 days. I think could be a significant improvement for you. And let.
Sonya Turner (38:10) Me ask you this since you said that. Do you see commonly when you, because as you said, the two groups kind of being siloed right now, do you see typically that people health care systems have a stronger Roi or a more complete process when the entire… program is outsourced to you all, rather than keeping it siloed? And I know that’s probably a double edged sword, you know. But, and I don’t oversee medical staff. So I’m just literally asking because I know that there, I believe that there’s benefit in having the whole process go. But again, I don’t oversee that team. So that’s why I’m asking you, do you see a huge difference in those individuals that choose to do both pieces in the entire process over a group who chooses only to do like pay or enrollment?
Mallory Smith (39:15) I think it’s a great question. I can definitely see you’re familiar with the industry. It is what we typically see to answer your question. Yes, we see an astronomical increase in Roi whenever it’s comprehensively outsourced. Just because everyone that’s a part of your organization now has access to the same data. It’s one question being asked for the providers. It’s one area to store everything. We of course, have role based access control. We have teams management. So if you want to keep the med staff teams, they will see their areas, your teams, they will see your areas. It is a smoother synergy just from start to finish. We also have some that we do a crawl walk run approach where they’re one of their two teams is very insistent that their process is fine. It’s not broke. Don’t try to fix it. So in that case, their team is still able to use and access the medallion platform. They can still store their information in the medallion platform. So it’s a little bit of a compromise in those situations where if your med staff team is not open to that, they could at least still have one central platform. And then typically, what happens when we get to phase two, is we’re able to show them well, this is how much we’ve been able to improve the enrollment process, the delegation process. Would you be open to exploring with the joint commission and they usually reallocate their staff and then it’s successful from there. And do.
Sonya Turner (40:38) you typically have because I know that for the med staff piece, they present the providers to like the med staff board, and then they vote on that piece of it. So typically, how does that work? If the whole piece is outsourced? Do you usually see people keep an fte for that function? And then working and seeing that information in your platform, and then that person presents to the internal med staff group. And that’s how that piece works. Yes, it’s.
Mallory Smith (41:09) pretty much exactly like that. The other great thing though is we have a fully electronic voting and committee portal. So everything’s all on the same platform. You’re able to see if you think about just the trajectory of what we’ve seen in history, you take a med staff file. It’s 35 pages thick. You print out copies, you pass it around the table. Everyone votes. The committee meetings take three to four hours with medallion. Everything is electronic. You basically give committee members access to the system. They have read only access. They have the ability of editing making notes. They can leave if they are saying that it’s approved, if it’s not approved, if it’s approved with contingency level one, level two. When you think of the different committees. So everything is just done within the platform. You can basically grant access to anyone on your team that needs to see that information. They can vote within the platform. They can run their committee meeting within the platform. And that way instead of a three to four hour monthly meeting that they will have to attend, they’ve all voted asynchronously one person had time at nine PM1 night, while the other one had time at two P. M. They’re able to see each other’s. Notes, they’re able to see how they voted. Their meetings are now 30 minutes on average is what we hear just because they pull up the files on the screen or they’ll share their screen if it’s like a teams or zoom call. And then they’re able to go from there.
Sonya Turner (42:34) Thanks, mal, I’m going to?
Mallory Smith (42:36) Open another?
Erica Lloyd (42:37) Can of worms here? Because it’s relevant. Let’s talk about reporting that’s a big value proposition here. So obviously the visibility is a matter of saying. So you can see as you’re saying, when you’re trying to schedule today, how does your med staff? How do they know when to schedule someone like a provider? If they’re in network with a certain payer? Is there a way they can easily see where to do the scheduling? So.
Josh Larkin (43:09) That typically comes from our team notifying the office manager and operations of where the provider is within their payer enrollment process. So we, right now, because we are siloed, we have two separate systems, med staff has a system and then we have a system, our system keeps all of our effective dates and the caqh information that we are required to track. And then we present that to the office managers and operations so that they are aware. And then ultimately, it’s up to them whether they decide to schedule patients with that provider or not.
Sonya Turner (43:52) Yeah. So, thanks.
Erica Lloyd (43:54) For that. So that’s one of the areas where if you have everyone on one system, we can have visibility that’s another thing is a lot of times from a reporting standpoint, and I’m calling it reporting, but it’s really just, it’s visibility but you don’t know, it’s really hard to track that manually. Is that, are you doing that just on like spreadsheets right now?
Josh Larkin (44:13) Yes. Okay. And.
Sonya Turner (44:15) So, would there be like a dashboard that you all have? Yeah, That would be nice. We’ve.
Mallory Smith (44:23) got all the bells and whistles.
Sonya Turner (44:25) We’re trying, we’re trying to tamp down our excitement… yeah, dashboard because that like there are a lot of reporting that is manual right now, not just in this area but just across the organization as a whole. There’s a lot of manual reporting and not a lot of hbi type reports and dashboards. It’s you having to go run the data and have it pulled back for you. So if that information was in a dashboard so that people could easily click and see, you know, for. So we have about 68 practices… on the CMG side, that are physical locations where providers can see patients. So if someone could go in and say, you know, one of our practices is like CMG danville so if they could go to the dashboard and see for my CMG danville providers, where am I? Like? That would be awesome because then they’re not having to scour through a spreadsheet. And I think, you know, anytime you say dashboard, people’s ears perk up because it means less work manually that they have to do. And the visibility being there. So that would be a huge win because we don’t currently have that or… an either side that I’m aware of.
Mallory Smith (45:55) Yeah, no, I think it’s a great call out. I would probably add to that and say, of course, we have the analytics. We can grant access to anyone on the team that needs access to see them. You can export them. You can add them to your leadership presentations. You’re able to level it up from that aspect. The other great aspect, if you have someone that just says, I don’t want to have to click into a platform and check something, we have reports that your team can either create or that we actually have created for you that can be in their inbox every single day. So if they prefer more of a sit down with your coffee, go through your email, see if there’s any participating providers that are new from yesterday, then they can get a daily report. It could be weekly monthly, quarterly, whatever you prefer. So we kind of give the either or option there. If you have someone prefers visual dashboards and they’re okay with clicking into a system. There’s some that are just adamant and they say, no, send me a report and that can be in their inbox automatically through the system.
Sonya Turner (46:53) We can’t help solutioning. I’m sorry, it’s okay. We’re trying to.
Erica Lloyd (47:01) Diagnose and then solution, but we can’t help ourselves.
Sonya Turner (47:04) But it’s helpful because I think it is, gives us is specifically me, gives me more information to be able to take back to rob to have the conversation, and to say, yes, we need to further explore this and here’s the benefit on both sides. So I think it’s helpful to have the solutioning along with the offering. And what you have is helpful because it’s… easier for us because we understand the process. But for someone who’s you know, rob is 30,000 feet. So I’m gonna have to break it down and give it to him in bites. You know, that makes sense. So it’s very helpful information to know. Yeah.
Erica Lloyd (47:51) And, I think we’re getting excited because I think there’s just a lot of areas that we could support you there. And I think just from a cost lens there’s a lot of areas we’re seeing just at this first pass of optimization… from between ftes software like just different things like the denials. Typically we’re even seeing a big like sometimes where you can find millions in the couch cushions is just the salary you’re paying these heavy, you know, heavy hitting providers to sit on bench and that’s an area that we can recoup.
Sonya Turner (48:25) So,
Erica Lloyd (48:25) I think there’s a lot we can do here.
Sonya Turner (48:31) I think.
Erica Lloyd (48:31) there’s a lot of value in showing you a demo of the platform. And I think there’s two different ways that we should probably do this. Like obviously, there’s a software and service component. So usually we show first the software component and then we do a second demo that we call a, you, do we do?
Erica Lloyd (48:52) Which we say, okay, here’s. Now here’s a kind of a demo of services where we go a little bit deeper into the weeds and say, okay, based on this, here’s, the work that medallion would do here’s, the level that you would need to retain staff. And typically, we could say one fte service to every five between 500 and a 1,000 providers depending on the types of providers you have. So that’s kind of like the optimization and we can go deeper into what that looks like. Like we’ll get deep in there of like, okay, for your delegated agreements here’s. What we’ll take care of here’s. What you’ll be responsible for here’s. The outcome. And you said one.
Sonya Turner (49:35) To 5,005?
Erica Lloyd (49:37) 100. Sorry, between 500 and a 1,000 depending on the type of providers that you have. And depending on a couple of different things, conservatively, they tell us to say one to a 1,000. I’m being conservative in saying one between 500 and a 1,000 also because you have it siloed in two different groups, you’d probably want one for medstaff, one for this team.
Erica Lloyd (50:02) But I mean, if with benefits and everything, we typically see anywhere probably 80 K or so per fte. There’s there’s some couch cushion money, right?
Sonya Turner (50:17) There that’s definitely couch cushion money. Yeah. Oh, that’s recliner, couch cushion and car seat money, and.
Josh Larkin (50:28) I would assume too. Oops, sorry, I would assume too, you guys do like referring providers as well for the clinical credentialing, where we don’t bill for their services, but they have villages at the hospital.
Mallory Smith (50:46) Sorry, can you repeat that? It sounds like you’re referring to hospital applications, yeah.
Josh Larkin (50:51) So, like on the medical staff side, we do have some providers that have privileges at our hospitals that go through the medical staff office through for clinical credentialing, but we don’t bill for their services.
Mallory Smith (51:03) Yes, yeah, thank you. We are comprehensive. We’ll do internal joint commission level privileging voting committee and so forth. And we also do external hospital applications. If it is a custom form. It sounds like you are the hospital though, and you just have providers from around the area that need to provide services at your hospital, is that correct?
Sonya Turner (51:23) Correct. Okay. But then they bill for their own professional services and we just bill the technical hospital stay. Perfect. Yeah. So.
Mallory Smith (51:34) We basically identify them in the system as just partners so that, you know, that they’re not a part of your direct provider roster but that they do have admitting arrangements and it of course has the privileges broken down there.
Erica Lloyd (51:46) Okay. Let’s start. Okay. Oh, wait, I think it’d be good. Let’s if you’re open to it, let’s schedule out the platform demo. Does that, do you want to see that? Okay. Let’s do that? And then as I’m scheduling that I want to just, I’ll.
Sonya Turner (52:07) have I’ll just?
Erica Lloyd (52:08) See which of these? And sorry, this one shouldn’t be here… that one’s for our payers. But, okay.
Sonya Turner (52:17) Here.
Erica Lloyd (52:18) Let’s let’s actually just look at the calendars first and then we’ll just go through what we’re going to show you in the platform to make sure we’re not over rotating on what to show you and let’s I guess for timeline, what’s the, when are you thinking about making some type of change here? If?
Sonya Turner (52:38) I had to answer for rob, I would say that he’s looking for sooner rather than later. I have a meeting with him one on one tomorrow at 11. So, if we could at least give us a week before we schedule a demo, because I want to touch bases with him and see exactly does he want to just focus on payr or does he want to include… mdstaff as well? Because I don’t know the answer to that, then that will give me an opportunity to at least have a conversation with him to see what the appetite is. So, if we could, at least, you know, schedule out that far, that would be helpful.
Erica Lloyd (53:27) Yeah. Let’s do it. And I guess, do you know? Because it was Bob booz that left, do you report directly to rob now Sonia?
Sonya Turner (53:38) Yes, I do. And we’ll until April the twentieth. We have the new interim starting but he kicked this to me and said, you know, see if you’re interested, have a conversation. So at this point, I’m taking it as I’m taking it perfect. And.
Erica Lloyd (53:59) I mean, I think you have the very deep qualifications here. Okay. Does the team have, how about the ninth? So I’m going to be out next week, taking the kids to spring break. How about the, how about the ninth?
Sonya Turner (54:17) If that works? We’re.
Erica Lloyd (54:18) open from nine… anytime between nine and 12, and then again at three, so.
Sonya Turner (54:26) I know I’m out on dto from I’m taking actually the week of Easter and I think Nicole’s taking her child because her baby girl is on spring break that week. Oh, so then that would push us to the week of the thirteenth.
Erica Lloyd (54:43) Yes. Okay. Let’s do, where… could you do Friday? The seventeenth day in, would like at 10 10 or 11 a. M. I.
Sonya Turner (54:58) Can do either one of those. Okay. Let’s do I’m gonna, I don’t know about the other, Nicole and John? Yeah, yeah, that works for me. I can make it work. Yeah.
Erica Lloyd (55:07) Perfect. Alright. I’m gonna put us in for 10 o’clock on the seventeenth. And then, and I’ll send the invite out to everyone, of these will.
Sonya Turner (55:20) You be sending it out with teams or zoom? Oh, I have, you know, what do you?
Erica Lloyd (55:27) Is it, do you want to do it on teams?
Sonya Turner (55:30) Is it okay if I, if we can, because zoom just doesn’t work well for us. So I can get Olivia if you, because I think Olivia scheduled this. Yeah. So if you want to just email Olivia and let Olivia know we need to have the setup for the seventeenth at 10, then she can send that invite out from my calendar. Okay?
Erica Lloyd (55:54) Sounds good. And.
Sonya Turner (55:56) I would say if you want to schedule for maybe an extra 30 minute buffer on the end of it to make sure that we have enough time, because then if we finish early, then that’s fine. But I want to make sure that you all have enough time to get through because we usually have a lot of questions. So just want to make sure that we have enough time for that. So, if you want to do 10 to 11 30, I think we could make that work and would be better to have more time and finish early than not enough agreed? Okay?
Erica Lloyd (56:29) Good. Call out. I’ll email Olivia and Cece, all of you after this in our last three minutes here. Do you want to Mallory do lightning speed just to make sure we’re showing you the right product SKUs, in the demo?
Mallory Smith (56:44) Yes, of course. Okay. So this will probably be a little bit more fine tuned once we hear back from your team if you want to see the medstaff side or not. But for now, if I were to do a comprehensive demo for both sides, I would show the platform which is provider data management, just that core piece of the software monitoring. So this would be comprehensive monitoring to meet joint commission standards. Checks, the national practitioner data bank, oig, Sam, medicaid, exclusions, medicare, opt out things like that, direct payer, enrollments, so delegated and non delegated, we’ll cover as.
Sonya Turner (57:19) a part of it the.
Mallory Smith (57:20) Cvo credentialing again, if the medstaff joins, that could be the ncqa or the joint commission standards privileging for the medstaff. My last question for you though actually is licensing. So as a part of the core platform, we do track the provider’s expirables, we’re able to automatically send out notifications. We also offer licensure as a service. So if you have any cross state licensure, telehealth, opportunities for your providers, renewals of those medical licenses, is that something your team currently manages for those providers or is that provider owned?
Josh Larkin (57:55) It’s provider owned, and then they work directly with the, their office manager to get reimbursement for those fees while.
Mallory Smith (58:05) they’re employed by accenture. Okay? Then we’ll leave that part off. Go ahead.
Sonya Turner (58:11) Yeah. But I’m gonna ask rob because I know that is a lift also on the provider side and the office manager side that sometimes it’s very hard to keep up with. And like I said, they’re trying to figure out how to… reduce workflows in every way we can and touches.
Sonya Turner (58:36) So I would say for right now, leave it on and it’s something that I can make sure that I include in my conversation with rob.
Mallory Smith (58:45) Sounds perfect. Yeah, absolutely. The way that we do the licensure, of course, we do for every provider type, whether it’s an RN all the way up to MD and do. But essentially, we will actually cover the charge of it and then we’ll just treat it as a pass through fee back to you. So rather than those providers having to request reimbursements, I have to request reimbursements from work all the time for travel. I know what a pain that is. So we can definitely have that conversation. I can include it. Okay? Huh. Yep. Erica, looks like the full kitchen sink.
Erica Lloyd (59:20) So, I’m glad we’re doing an hour to ask because it’ll there’ll be questions and it’s a, you know, it’s a multi platform. It’s a like a multi module platform. So, we’ll go in depth on that. Okay? And I’ll send you this deck as a leave behind to socialize with rob and I’ll just send you some key bullets after to the team and say, hey, based on our conversation here’s, where we think the value could be, where we’ll continue exploring. But here’s where we’re at the initial pass, we think that there could be some synergies.
Sonya Turner (59:51) Perfect all.
Erica Lloyd (59:53) Right. Well, it’s great to meet you and.
Sonya Turner (59:55) I’ll yes, it was nice to meet you all as well. And,
Mallory Smith (59:58) yeah.
Erica Lloyd (59:59) Definitely.
Sonya Turner (60:00) Excited about the opportunity even if the opportunity only exists on the enrollment side, we’re excited, but I think that there’s an opportunity here to realize more than what probably meets the eye. And yeah, really excited to see the demo and to at least share back the initial information with rob, and get this ball rolling to see what we can do and how we can collaborate. I love it. Thank you so much. It’s nice to meet you.
Erica Lloyd (60:35) Nice meeting, y’all, nice.
Mallory Smith (60:37) To meet you as well.
Sonya Turner (60:38) Bye.