Transcript
Jacob Andreasson (00:00) hey, Devin.
Devon Murray (00:02) Hey, how’s it going?
Jacob Andreasson (00:04) Good man. How about yourself?
Devon Murray (00:05) Good. Is it Jake or Jacob?
Jacob Andreasson (00:10) Friends, I was told earlier in my career, Jake sounded unprofessional. So, while I’m on the clock, it’s typically Jacob, but you can call me Jake.
Devon Murray (00:19) That’s good.
Jacob Andreasson (00:20) Right on, man. Well, appreciate you taking the time. How’s your Wednesday going?
Devon Murray (00:23) It’s going all right. How about yours?
Jacob Andreasson (00:25) It’s not too bad here. I saw you’re obviously in Helena now, but are you from Utah originally? I saw you went to, I think BYU, right?
Devon Murray (00:32) I’m from Colorado originally, but yeah, I went to BYU and a lot of my family’s in Utah. Yeah.
Jacob Andreasson (00:38) Nice. I lived in salt lake for three years. I actually just moved back to California about a year ago.
Devon Murray (00:43) Okay. Nice. Where in California?
Jacob Andreasson (00:46) I’m in San Diego? Okay, great. Yeah, cool. Well, you know, quick intro. Obviously my name’s Jake, I’m on the partnerships team here at medallion.
Jacob Andreasson (00:55) I’ve been with the organization for three years now. I think the goal of the call today is pretty simple, just I want to put you in a position to determine, you know, if it makes sense to continue the conversation. So would love to understand a little bit about how you’re handling provider onboarding credentialing today, why, you know, decided to take the call. I’m sure you had a ton of emails and then if you were to make a change, what that success would look like. So I think with that understanding, I can share what we do with similar organizations. And then we can kind of make a decision from there. Does that sound good? Was there anything else in particular you were looking to cover?
Devon Murray (01:31) No, I think that sounds good to me.
Jacob Andreasson (01:33) Perfect. Cool. Well, with that, yeah, I would love just to understand a little bit about your role and then, yeah, kind of what that onboarding lifestyle, life cycle looks like and maybe kind of the fundamentals underneath it.
Devon Murray (01:45) Yeah, no, that sounds good. So, I’m the revenue cycle director at st Peter’s I’ve been here just a little less than 10 years now. So the, I guess at st Peter’s there’s two pieces to our onboarding. We have like the, you know, like provider credentialing which is our medical staff services and they take care of all of the onboarding piece. And then the payer enrollments and credentialing falls to my team. Okay? So, I, you know, I think I had mentioned in an email, we’ve looked at a lot of different solutions right now. We have one and a half ftes and they pretty much do that is all they do. I mean, they’re doing payer enrollments. We have about… 180 employed providers right now and we have a lot of locums that kind of float in and out. And so we’re always, we’re probably always, you know, have our hands in 10 to 15 different providers at a time, whether that’s re, enrollments or new enrollments for providers. And so like I said, we’ve looked at a lot of different solutions and I feel like kind of what it’s come down to with every solution is either we’ve… you know, either it looks really good and when we’ve kind of tried it out and tested it in practice, it’s there’s been so many gaps that we have to fill manually that either takes… up enough of our staff members’ time that it’s not worth it or adds on to the length that it, you know, the time length that it takes for us to get enrolled, with our payers?
Jacob Andreasson (03:34) Yeah. So counterproductive.
Devon Murray (03:36) Yeah, that, it just hasn’t yeah, it just hasn’t been worth it. So, I think really kind of the two things that I’m looking for, is there a solution that will save enough of our staff members’ time that it’s worth paying for? Or… is there something that will save enough time from, you know, the date that we get the paperwork to finalization that it would be worth it? Maybe even, you know, maybe paying a little bit more knowing that we’re going to be able to get those providers in and get them going in a quicker in a quicker timeframe? Yeah.
Jacob Andreasson (04:11) So it sounds like revenue acceleration, is important to you?
Devon Murray (04:15) Yeah. Okay. Yeah. And I mean, I, yeah, and I don’t even know that it’s like the revenue acceleration I think for the, for.
Jacob Andreasson (04:25) the.
Devon Murray (04:26) for the most part, the issue that we’re running into is we have providers that are like sitting there, right? And so that’s a huge frustration for a provider if we’re telling them that, yeah, you know, like I know that you finished your residency in August, but we can’t get you in until October because we didn’t get you signed early enough or like we have it, we have a gap in our practice that we want to be able to fill in with a locum, but we can’t you know, someone just let us know last month and so we don’t have enough time.
Jacob Andreasson (04:57) Yeah. And are they on payroll just kind of sitting?
Devon Murray (05:02) There. Well, usually not. So, yeah, I mean, we have a pretty good like, our provider recruiting team is really good at working with us beforehand. So, like, and we have a, we have a pretty consistent process. So, like if they’re you know, if they come back to us and say, hey, we have this provider. They’d love to be able to start this date. We’re usually able to come back to them and say, yeah, like we’re going to need to push it back or, yeah, I think we can make that work. So, I, we haven’t really had very many cases where the providers sitting there being paid doing nothing or where we’re missing out on lost revenue. Yeah. So it’s yeah, it’s not as much from like a revenue perspective as much as it is just kind of a provider satisfaction.
Jacob Andreasson (05:48) Okay. Cool. That, that’s good to hear. I appreciate the background there. I’ll I don’t want to inundate you with slides, but I do have a couple I’ll pull up later that I think could help guide the conversation. But really from what I’m hearing provider credentialing handled in medstaff, you’re more overseeing the payer enrollment piece, the one point five or one and a half ftes. Is that just on your team or is that between the two teams? Yeah.
Devon Murray (06:10) That’s just on my team. Okay, I think that I don’t know that we even have a full fte on the actual like hospital credentialing piece?
Jacob Andreasson (06:20) Okay. Got it. And then, when… so obviously you’ve tried different solutions in the past, do you have anything in place right now or is it just spreadsheets and, you know, elbow grease so to speak.
Devon Murray (06:35) So we use verity to a, really limited degree. Okay?
Jacob Andreasson (06:44) Great. Awesome. And when you say limited, is it more just kind of a data repository?
Devon Murray (06:49) Yeah. Essentially. So, so we, it started out because, our like privileging department used that and so it was a, it was a good place for us to store like any documents, that we both needed. It was a good place to store it. We, we were using it to kind of pull applications, and help with our caqh. But we didn’t we’ve since stopped using it for caqh. And so there’s just there’s maybe two or three payers that we will pull like it creates the documentation for us, but it’s like I said, it’s pretty limited. Okay?
Jacob Andreasson (07:29) Got it. And are you, do you guys do direct enrollments for all payers or are you delegated with any?
Devon Murray (07:34) We do have delegated credentialing for a handful of payers. So we have, I, we have like… I don’t know off the top of my head, but it’s 13 or 14 different payers that we enroll with and, we probably do delegated credentialing for three or four of them. Okay?
Jacob Andreasson (07:56) Got it. That’s. Exciting. A lot of groups come to us with this whole, you know, focus of getting delegated with payers. So obviously in terms of turnaround time, that’s kind of the holy grail. So, that, that’s exciting. Do you guys have any interest in expanding that mix?
Devon Murray (08:10) No, honestly. So, so, the ones that we’re not doing delegated credentialing it’s because either we’ve tried it and it was, and it ended up being slower or they don’t offer it. We have a lot of, we have a lot of small groups in Montana that just don’t have it’s not something that they offer.
Jacob Andreasson (08:31) Okay. Got it. Can, you know, super high level. Can you like walk me through what it looks like from, you know, I guess when a provider accepts their offer to getting through mdstaff when they get handed to you. And then finally effective date. I’m trying to just understand maybe where some of the delays are and where there may be an opportunity, to accelerate that?
Devon Murray (08:51) Yeah, I’m and I’m probably not the best person, to walk through this but I can, at least I can give you a, very high level. So, yeah, perfect. I, you know, like we have, we, as the recruiting team is working through providers, they’re pretty good at sharing the pipeline with us.
Devon Murray (09:08) And so they’ll let us know that, you know, we have this provider. We think that we’re going to be able to close with them or we’re close to getting a contract. And so they’ll start initiating that usually about a month before we actually sign the contract with the provider, as long as we, as long as it looks like things are going to get in order. Yeah.
Jacob Andreasson (09:27) That’s great. And.
Devon Murray (09:28) so, we’ll start reaching out to them at that point in time and saying, hey, you know, we’re excited, that we’re close. And, you know, if you feel comfortable, we’d love to start gathering some of that information. We have a like we have just kind of a stock email that goes out with these are all the things that we need from you. It kind of depends on the provider. We have some providers that are really anxious and are happy to start sending it. Then we have some providers that say, hey, I’d like to get something in writing before I actually send over any of my documentation. And then we have, and then the biggest delay that we have is providers that don’t have all of the documentation that they need at that point in time. Like, you know, they might’ve just finished their residency and they don’t have, you know, they don’t have their license in order or they don’t have their Dea in order. And so, I think that that’s kind of that’s the biggest challenge on the internal front is just like circling back around with all of the providers to make sure that they get their documentation in. We haven’t had that. I mean, we haven’t had many challenges with that. I would say most of the challenges that we have on that end are from the locums companies that we work with, cause we’re usually working with a representative from the locums instead of like the provider themselves. And so we’re kind of having to go through that.
Jacob Andreasson (10:55) Yeah, yeah.
Devon Murray (10:56) Which is just a little bit slower. So from there, I mean, it usually takes our team if we have all of the, I mean if we have everything in place and everything’s fine, it will take our team a week to turn around everything. On average. It usually takes two or three weeks just because there’s usually something that’s missing or something that we have to go back to the provider. But from the point that we reach out to the provider, to the point that the documentation is in, it’s at the most three weeks. Okay? And then the biggest, I mean… waiting on the payers to respond to us and approve, we have most of our payers are 30 to 45 days, but we do have two groups that are 90 days. And so we’re kind of at the mercy of them, waiting for them to respond to us. Got.
Jacob Andreasson (11:53) It, and are those payers that are a little bit bigger? Are those like bigger payers for you or I guess in terms of like revenue share?
Devon Murray (12:00) Yeah. They’re actually super. They’re actually really small. So one is pacific source, which is like, you know, four percent and the other one is united which would, you know, is usually big, but for us is like two percent of our revenue. So they’re both pretty small. And we have, you know, like we have gone forward with some providers. If they’re really anxious, we have gone forward and we’ll just say, you know, we won’t schedule anything from these two payers.
Jacob Andreasson (12:30) Okay. Got it. And then the 30 to 45 days is that for payers you’re delegated with?
Devon Murray (12:38) No, that’s usually the payers that we’re doing direct credentialing with. Okay?
Jacob Andreasson (12:44) That’s great. And then for the payers you are delegated with, is that shorter?
Devon Murray (12:51) Yeah. So most of the payers that we’re delegated with right now, they’ll just accept an updated list. Fortunately. So they’re so yeah, that’s why I said that we have chosen not to be delegated with some payers because most of the ones that we are delegated with, we’ve we kind of just, we have a really quick process where it turned it should turn around in a week or two.
Jacob Andreasson (13:15) Okay. Got it. That’s awesome.
Devon Murray (13:17) It’s just a matter of them getting like we just send them an updated list or, you know, an updated roster and then they just need to get it into their system. But almost all of them, if we let them know, they’ll backdate it as well. So, it’s really, a pretty quick process for them.
Jacob Andreasson (13:35) Okay. That’s great. And then last question that I can jump into a little bit on medallion here, you know, I saw like I think it was open provider roles on your guys’ website in terms of like a rally cry by, you know, leadership? Is it, is it growth? You know, are there, is there anything coming down from the top that’s you know, a big initiative right now?
Devon Murray (13:59) No, honestly, the, so the only area where it’s interesting because we’re a small community. And so, I think that there’s some roles that it’s like, yeah, if we can, if we can find a provider, we would love to have that specialty, but most of those, are not roles that we’re like heavily recruiting on. I would say the only area that we’re like act, you know, like heavily recruiting is for our oncology, we have a medical oncologist that we’re trying to replace at this point in time.
Jacob Andreasson (14:33) Okay. Got it. And in terms of acquisitions, I know you guys acquired, I believe it was an orthopedic clinic, right? Not too long ago. Is that like an active strategy for you guys or does that just kind of make sense at the time?
Devon Murray (14:46) Yeah, it just kind of made sense at the time, we’re not usually actively acquiring. I mean, it’s happened a couple of times in the last few years, but it’s not something that we’re trying to, you know, trying to reach out to provider groups and do that.
Jacob Andreasson (15:02) Okay, cool. No, that absolutely makes sense. Let me go ahead and share my screen here and I can share a little bit about what we do… let’s see.
Jacob Andreasson (15:15) Awesome. Can you see this? Yep? Perfect. So what kind of separates medallion from, you know, other solutions that you may see in the space is that we, we’re an end to end solution. So we’re going to automate about 90 percent of the process. Obviously, there’s things that, you know, you’re always going to need a human in the loop for whether it’s from a compliance or just a quality aspect. So, you know, there’s some things that we can’t but 90 percent, we’re going to largely automate most of it. So this is kind of the whole spectrum of, you know, products and offerings that we’re able to provide. I know we talked about the direct payer enrollments and then, the privileging also before providers get to you. But do you do anything for like licensing or anything like that for your providers? No?
Devon Murray (16:06) That’s that’s all done with our… privileging team? Okay?
Jacob Andreasson (16:11) Got it. Yeah. Well, really the goal of what we’re looking to do here is obviously, this process, is very antiquated. You know, I’d say a majority of groups that we speak with are still, you know, maybe they have some sort of data repository that they’re using like a very stream or something like that. But for the most part, it’s really, you know, still being managed by people. It’s a lot of manual touch points, you know, sometimes, it groups will have to build out very large in house teams, things like that just to kind of get from point a to point B. So we’re looking to fundamentally change that. So we want to offload as much of the manual administrative, repetitive tasks from your team as possible to free them up for more strategic work while we’re letting technology do things faster more accurately and at lower cost.
Jacob Andreasson (17:10) So, just talking about a couple of the reasons that groups will typically partner with medallion, it’s usually, these are kind of the three areas we’re able to move the needle. So the first, is the revenue acceleration piece. Typically, you know, we’re able to cut down turnaround times by, you know, five to 10 days from probably where you’re seeing right now… and again, every day a provider is not seeing patients as potential revenue that’s being left on the table. It sounds like that’s not a huge piece for you right now, but again, it’s they’re seeing patients faster. They’re happier essentially, it’s a win. So to speak, do you, how is your guys, you know, do you guys see any claim styles related to credentialing or anything like that?
Devon Murray (17:57) It’s it’s pretty rare. I mean, most of the time that it happens, it’s when we do get those denials, it’s just like a payer glitch. And yeah, we’re able to reach out to them and say, hey, we need to work through this got.
Jacob Andreasson (18:12) It.
Devon Murray (18:13) that.
Jacob Andreasson (18:14) makes sense. So, I guess from taking it from, you know, the beginning where medallion is really able to start speeding up the process is we are the only vendor in the space that has a direct integration with caqh, so we can pull in about 90 percent of the data that we need to start kicking off the payer enrollment process automatically. So, I think onboarding to medallion to getting a provider fully set up in the medallion profile, we’re averaging with two days right now. And I mean coming from obviously two to three weeks is on, the later end. But would that kind of time savings? How would that impact you guys? Yeah.
Devon Murray (18:54) I mean, that would be great. Can you walk me through what that process? Like like when you say kind of automate that process? What does that look like? How does that go out to our payers? And… what, you know, what are you pulling from to make sure that we get everything we need? Yeah.
Jacob Andreasson (19:12) So, we essentially have a payer directory built into our platform. So, you know, I actually have never encountered a payer that we don’t work with in the country. So we know how these payers like their applications, everything like that. It’s all built into the platform. And once we have your provider’s data in there, we use automation to form, fill these applications and get them out the door. We have, you know, AI agents that are following up with them via the phone, the email, things like that. And since we work with them on, you know, such a consistent basis, we know how they like to be followed up with, we know how applications need to be sent. So, while we’re doing all those, you know, offloading all of those manual touch points, things like that to our automation, you’re able to track that progress within the platform. Awesome. Did that answer your question?
Devon Murray (20:05) Yeah, I think so.
Jacob Andreasson (20:06) Okay, cool. And, you know, if it, if you do want to see a demo, it’s obviously a lot. It’s probably easier to see a visual learner as well. I can only speak to it so much but we can show you what that process looks like as well.
Devon Murray (20:19) Yeah, I’d love that. And I’d love to also see the like the list of payers that you have. Again, we’re just, we have a ton of small payers. And so I think that’s always a question for us. Yeah.
Jacob Andreasson (20:30) Yeah, absolutely. So, yeah, that’s the first piece is, you know, every day that we can get back is, you know, providers seeing patients sooner and you generating revenue sooner as well. The second piece is reducing operational costs. So it sounds like you guys have a pretty good handle on this, you know, right now, but we’re typically able to reduce the cost of these functions or, you know, in a situation like this, more likely free up your team to focus on more strategic initiatives because a lot of these, a lot of the manual work that they’re doing when it comes to payr and all the things like that, we’re going to be automating that. So I don’t know if it’s you know, when you think of time savings that your team could get back. Like what could they, I guess be doing if they weren’t bogged down in this stuff?
Devon Murray (21:18) Yeah, I mean, I think that we would love to have, we would love to have both of those, you know, both of our employees do other things if we have the time to be able to do it. I think it’s just, yeah, how much time can it actually save them?
Jacob Andreasson (21:35) Yeah, yeah. And you know, this is a scenario where really like we would need the provider, we would need them to invite the provider to the platform. And then you go into the platform and you submit a request. I need X provider enrolled with y payer. They’re able to track every step that, you know, our technology is taking until that provider has reached their effective date. So, you know, we have the reduced operational costs up here because transparently, we’ll talk to some groups like I’ve talked to 100 provider groups who maybe have headcount of like four people, four to five people. And that’s like that’s some pretty serious operational bloat to where you could probably get by with, you know, maybe one fte or half an fte even so that’s kind of where that piece comes in. But this is absolutely a situation where we can free your team up to focus on more strategic things. Awesome. And then the last piece which kind of you touched on at the beginning is removing provider abrasion. So providers are great at a ton of things, right? Data or not data. But getting you data and filling out paperwork and things like that is usually not one of those things. So we want to take as much of that work off the provider’s plate as possible. We want to get them seeing patients as fast as possible. We want to make them obviously as satisfied as possible in their onboarding experience, increasing retention and just creating a better experience. Overall. It’s kind of what we’re focused on there. So this is another thing that you’ll be able to see in the demo? Perfect. Awesome. Anything, any questions I can answer there?
Devon Murray (23:23) No, not so far. Okay.
Jacob Andreasson (23:24) Great. And then, I guess, you know, when you think about which of these, I guess if you were to make a change, say 12 months from now, whether it’s with medallion or something else. And you’re looking at kind of how you’re metricing these, which would be kind of the most important, or would you like to make the most ground in?
Devon Murray (23:44) Terms of pursuing definitely reduce operational costs is the biggest issue for us. Okay?
Jacob Andreasson (23:49) Got it. Do you have like a certain, I guess, is there a goal like a metric or something that you’re looking to reach in terms of operational cost reductions?
Devon Murray (24:00) Not necessarily. I think just be able to show a solid Roi, I mean.
Jacob Andreasson (24:06) Yeah. And would that be in terms of, you know, essentially, just like would that be reducing headcount or would that be just moving staff away from the credentialing enrollment process to focus on other things?
Devon Murray (24:19) Yeah, definitely moving staff away to focus on other things. Okay?
Jacob Andreasson (24:24) Yeah. Okay. That’s super helpful. Awesome. I think that’s really that’s all I kind of had in terms of explaining more. Obviously, I don’t want to inundate you with the slides too much, but it sounds like there is some alignment here. So, if it makes sense to you, I’d love to go ahead and set up a demo and continue the conversation.
Devon Murray (24:44) Yeah, that works for me. I’d probably love to get our director of that area as well in the conversation. Okay?
Jacob Andreasson (24:51) Great. And when you say director of that area, do you mean the med staff?
Devon Murray (24:56) No, just our just sorry, our… the person who leads our credentialing team.
Jacob Andreasson (25:02) Okay. Beautiful. Awesome. Do you have your calendar in front of you by chance? I do. Yeah… great. How, how… does your schedule look next week? Well, it looks.
Devon Murray (25:20) I’m pretty open but it looks like our, the leader over our credentialing team is out. So, what about the week after?
Jacob Andreasson (25:29) Yeah. How does?
Jacob Andreasson (25:38) Would… so, I’m trying to coordinate with my solutions consultant schedule as well here.
Jacob Andreasson (25:54) How would nine a. M work on the sixth Monday?
Devon Murray (26:00) Nine?
Jacob Andreasson (26:00) A. M your time?
Devon Murray (26:04) Yeah, that should work. Okay, awesome.
Jacob Andreasson (26:06) I will send this invite over and, I guess does, your director of credentialing? Does she kind of share the same sentiment of, you know, we want to free this team up to focus on other higher level initiatives?
Devon Murray (26:20) Yeah, I think so. Okay.
Jacob Andreasson (26:22) Awesome. Great. Well, I’ll send this invite over Devin if you just want to add them on there. That works great. But yeah, I’ll follow up with an email a little closer to then with an agenda. Perfect. Well, great. Thanks so much for the time today. Look forward to speaking, then thank you. Bye.