Transcript
Bradley Eral (00:00) hey, Karen. You got Brad here with medallion.
Karen Baker (00:02) Hi. How are you?
Bradley Eral (00:04) Doing well. How are you doing?
Karen Baker (00:06) Pretty good. I feel like I’m getting inundated with AI reminders that everything is having AI in it. I just got off a call with about 100 people in Lima. We have an office in Peru. We’re just doing a general announcement about an office thing and they had all the managers on it and we used copilot to help us with the planning of that about who was going to sit in, what area of a floor in a building that’s fine. Then we had prompts on the screen because a lot of the folks on there are native Spanish speakers and so you can listen in real time to the call in your language, unbelievable.
Bradley Eral (00:56) And.
Karen Baker (00:57) while you’re speaking or someone else is speaking, there’s a little button little thing that goes around the outside of your image. Yeah, little thingy in the corner that’s letting you know that person is being translated. That’s incredible. So, if you’re Spanish, you can hear it in Spanish. And if you’re English, you are, you know, depends on what the person is natively speaking, who’s the speaker at the moment. And then down below, there’s a different chat than the chat that runs on the side. For when you type, it will in real time, translate it to their language in text. So you don’t have to translate the text in the, you know what I mean?
Bradley Eral (01:33) Yeah, that, that’s that is crazy. And I’m.
Karen Baker (01:36) like my gosh, my God, it’s too much. It’s like so much it’s like all the it’s like all the things like imagine it, and it be right? Like, you just have to like, I was just,
Bradley Eral (01:46) going to say that like, yeah, the future is here. That’s that’s for sure.
Karen Baker (01:49) I mean, this, and this is a conversation about a non tech topic. Yeah, we want you to come into the office two days instead of one day a week and we have assigned days for your scrum teams to meet. Yeah, that was the topic of the meeting.
Bradley Eral (02:05) I could have translated that Uno two three. Oh, they had a lot of questions but.
Karen Baker (02:09) The point is like, you know, there’s like it was just the, you know, all the AI features and just that conversation, no.
Bradley Eral (02:18) That’s God, that’s nice for you guys though because I imagine like those meetings with Lima’s office are, you know, frequent, right? And just being able to break down those walls and have everyone be able to speak like have language, not be a point?
Karen Baker (02:32) Of friction a barrier. Yeah, we’ve got about 240 employees in Lima. We have about 700 in India. Okay. Wow. And in India, in both places, we have it as a requirement. They have to be, you know, conversational in English. They have to at least be able to understand written English. But of course, their speaking ability is going to vary, right? Because you’re going to have some people that, you know, their role isn’t really to talk to other people. You know, that, you know what I mean? Like they’re so it’s not, they don’t have to be as conversational as someone who’s say in HR, right?
Bradley Eral (03:06) Yeah, exactly.
Karen Baker (03:07) They got to be more so I.
Joshua Levitan (03:09) came into this conversation late, but I think what we’re talking about is live language translation. And I saw news recently that apple has patents for one of the future generations of the airpods.
Karen Baker (03:23) yes, our CEO just had them on his head. He was just apple iii just came out and you can do live translation while they’re in your ear.
Joshua Levitan (03:31) Crazy.
Karen Baker (03:32) Yeah. Well, on the call, I was just on, we were communicating with our Lima team and like the teams, the Microsoft teams, copilot, AI kicks in and automatically will translate into your native language for you based on your settings and you can pick it to do it different if you want, you know, and it also will convert the text in real time into your language, but it’ll translate Brad speaking in English to Spanish for me in real time.
Joshua Levitan (04:05) Out loud. Not in.
Karen Baker (04:07) Text. Yeah, out loud. Not in text.
Joshua Levitan (04:09) That’s incredible. Just unbelievable.
Bradley Eral (04:13) Oh, man. Well, we have an exciting topic. I can’t say it’ll be quite as exciting. We’re like.
Karen Baker (04:18) Flying in a plane with the internet is what we’re doing here, right? It’s like the comedian who’s like you’re flying in a plane and there it goes.
Bradley Eral (04:28) In.
Karen Baker (04:28) four hours and you have the internet and you’re complaining about what exactly?
Bradley Eral (04:33) Exactly that’s it’s so true. And then, Kara, I know your time’s valuable. Do you know, is Nicholas going to be joining or I would?
Karen Baker (04:41) Think so. Okay. She scheduled it so that we were both supposed to be available. Let me ping Nicholas. I haven’t talked to him in a minute. So let me,
Bradley Eral (04:52) we’ll give him a few minutes.
Karen Baker (04:54) I’ll just, I mean, we can keep talking about all the AI nonsense you want because I don’t know that I have a meeting now that isn’t about the topic of AI.
Bradley Eral (05:03) Yeah, I’m sure. Especially you, oh, this.
Joshua Levitan (05:04) One too.
Karen Baker (05:06) Exactly, exactly, right.
Bradley Eral (05:09) Here’s, Nicholas, no need to ping him.
Karen Baker (05:10) Oh, cool. Great. All right. Great.
Bradley Eral (05:16) What prompted the Lima office? It sounds like that’s been long standing, but.
Karen Baker (05:20) Yeah, we did an acquisition. So the company, so I joined qualifacts three years ago a little about three and a half years ago, hey?
Bradley Eral (05:29) Guys. Sorry, I’m late.
Karen Baker (05:29) Karen, sorry, I’m late. All right. We were, we were having a lively conversation about all the new features in copilot that will do real time translation while you’re in a meeting into your native language?
Nicholas Chepesiuk (05:40) My goodness. That’s crazy. So.
Karen Baker (05:42) We were just on with Lima, letting them know about their return to office that they have to go to two days a week in real time.
Karen Baker (05:47) You can have, you can have it converted to Spanish while the English person is speaking or vice versa, obviously just.
Bradley Eral (05:55) Crazy. It is crazy. But you said that? So the Lima office came via acquisition initially, well?
Karen Baker (06:01) They came through. We did so, the base company qualifacts built out a development team in Lima, and then as we kept adding acquisitions, we kept building up more and more teams there. So it’s mostly infrastructure. So they run all of our data center, you know, work and what we do at Aws etc. Most of that’s out of there. We have some development teams there, but we have, you know, development teams in India as well. And then in Canada as well for necklaces.
Bradley Eral (06:36) Wow. All over the place that’s awesome. Well, I know both are times valuable. So we’ll get some introductions here shortly, but before we do, I’ll say this really the goal today is further discuss kind of what brought us here in the first place as you look to reevaluate potential credentialing partners and then ultimately provide you both with enough information about medallion so you can determine look, is there enough alignment for us to keep talking or not? Both of which are perfectly okay outcomes for today. But does that sound like a good use of your time? Perfect. So, Karen, all of you lead the way from an introduction standpoint, me.
Karen Baker (07:12) Okay, great. So I am the CIO for qualifacts. So I kind of wear a few different hats here. But one of the hats I wear is I lead our revenue cycle management services practice. So there’s about 250 resources in that group and they are billers as well as collection, you know, resources, working denials, and that team rolls up to me as well as a small credentialing team. And then, the other hat I wear is overseeing our corp apps practice and our security team. So, both of which are really fairly busy. Yeah.
Bradley Eral (07:56) I imagine so. Especially these days. And then a quick question, you mentioned obviously all of our cycle rolls up to you the small cred team as well. How big is the cred team today?
Karen Baker (08:06) It’s like 10, maybe even less than that people. Right now, we had a, we had it primarily in the us with a few people in India. We’ve now moved it to where it’s still kind of that. But we had a manager here in the us that we have let go of. She wasn’t great. We currently have a credentialing solution. It’s really just the technology platform. It’s not like an outsourced partner for it, right? So, and all of our, all of our practices are behavioral health. So specifically, we have… therapy practices and some of them are growing very quickly. And this has become like a lead in, for revenue cycle services extension as we start in the bundle, like when we sell our software, because we have three ehrs, when we sell the ehr, we’re selling a lot of times, in the upper tier bundle credentialing because that sort of helps them, especially if they’re a smaller therapy practice to get quickly on, right? Like to sort of almost like, yeah, credentialing enablement so they can immediately start creating all of their claims and performing their services and everything. And so we’re needing to get a better technology partner to replace what we currently use. So that’s why we are seeking replacement.
Bradley Eral (09:31) Gotcha. That makes sense. I appreciate the context. And then, Nicholas.
Nicholas Chepesiuk (09:37) Hey, yeah. So I don’t have as much direct involvement, in this particular line of our business, but, I lead basically our kind of like we have like an AI product that sort of like bolts onto our, each of all of our platforms and it like it does a few different things like workflow automation with AI agents and document, clinical documentation, assistance with gen AI. And then we have kind of an interest in… billing related stuff. So like sort of, you know, presenting billing intelligence to our customers and automating like the billing matrix or so sort of like when a new payer contract comes in like updating all the rate cards and stuff like that customers have all with agentic AI as kind of an add on solution for our customers.
Nicholas Chepesiuk (10:37) So the main reason I, I’m on this call is just because, I got connected to your CEO like literally like six years ago or something.
Bradley Eral (10:48) And.
Nicholas Chepesiuk (10:52) yeah, I’ve always heard good things about you guys and Karen was just kind of mentioning, you know, some interest in just seeing what else is out there and so that, you know, you guys responded so fast which is awesome. So, yeah, excited to learn more. Yeah.
Bradley Eral (11:07) Well, appreciate you making the connection six years later and looking forward to the discussion today. And from our side, you have myself, I’m Brad E rall, director of strategic partnerships here. All that means is work with your peers, help them determine, hey, if and how does medallion fit into, you know, long term strategically where they’re headed. I also have josh levitin, who I’ll have to introduce himself. Yeah.
Joshua Levitan (11:28) Pleasure to meet you both. I ride shotgun here along with Brad more on the technical side and sort of process and industry focused… apologies. My camera’s going to be off today. I’m a couple days removed from a kidney stone surgery, and then also randomly got a jaw infection. If I turned my camera on, I would look like a chipmunk on one side and completely normal on the other.
Karen Baker (11:47) Oh, I’m so sorry.
Joshua Levitan (11:49) Thank you. I appreciate that. But to spare myself the embarrassment although I have, speaking of AI, Karen, I have been using Google nano, banana pro to generate a lot of funny images of myself as a chipmunk.
Karen Baker (12:02) I’m sure.
Joshua Levitan (12:04) Nothing like a little self deprecating humor, but yeah, pleasure to meet all of you and excited to chat here.
Bradley Eral (12:10) Yeah, hope both your weeks are going better than josh’s.
Karen Baker (12:13) yeah, no kidding.
Bradley Eral (12:15) But with that said, I guess a good place to start. Karen, it sounds like, you know, obviously today credentialing could be going better, right?
Bradley Eral (12:21) And it’s really ultimately serving as like a front door to, you know, kind of the front door to the revcycle services side. And of course, the ehr side, I’m curious, the experience today, I guess where is this surfacing up in the business? Like typically, we see like maybe a few areas, it becomes a point of friction with your customer base because of course, it’s like a small fraction of what you do. But if a poor credentialing experience, they identify that with all of qualifacts. So customer concern, customer turmoil and some frustration there. And then also, we see with some of your peers is, you know, obviously the inability to credential if it’s leading to denials can impact the rev circle or rev cycle services aside just from like a revenue perspective, right? But I’m curious like that’s typical scenarios we see. But tell me about where this is surfacing in the business today, as far as what lets you know this is something worth solving.
Karen Baker (13:10) I mean, I think you described it perfectly. I don’t know that we have any escalations of customers specifically because of credentialing. They probably don’t see credentialing as the root cause of the problem because that might imply that they’re not doing a good job of getting their providers to provide their information to get credentialed. Yeah, and that would make it seem like it could be their fault. So instead, they would say we’re not working their denials fast enough or we’re not getting the collections in the door and their Ar is aging out too far or something like that. And there must be something we’re not doing correctly in the revenue cycle. Yeah. I mean, those that are self aware might be aware of it, but most of our customers think of it as, hey, I’ve outsourced some of this function to you. Why aren’t you doing a better faster job of something? The ones that I think it would be interesting, sort of as a two prong play is for those that are small practice, we have a small practice, ehr, small market and those small market therapy practices. Like if the four of us decided to start a therapy practice, we’re not starting out with any of our credentialing done. And so that becomes a block in the implementation. And the interesting is sort of a dual different approach is, hey, here’s, a one time credentialing sort of effort that we’ll do to help get you sort of a quick onboard because it slows them down in their implementation of our ehr for the small market, right? And then they’re like resistant to like getting engaged and getting that ehr implemented and they sort of stumble and trip, stumble and trip through that. And then we could say, well, we did such a great job in getting your initial credentialing underway. Now, let’s get, you know, as so and so shows up with a different payer or you want to get into a different payer mix or whatever you’re wanting to do. We will continue that ongoing service and it looks like this, right? Yeah. So I think that would be that’s an interesting play. But we right now have a solution that we don’t really have very good automation or certainly no AI driven capabilities on. So that’s obviously just like basic block and tackle that you need. Now is the ability to also have good workflow and escalation management. We don’t the tool today. One of our gaps, is a desire to sort of set reminders or set escalations. Like, hey, this is set out there too long things like that, things that are incomplete and just reminding, you know, either something that we need to do or something that the practice needs to do to finish it out but things that are configurable workflows that will allow us to do this escalations through that. We have, some state licensing boards that are specific to us and so I can send you like a requirement stock, yeah, it has a bunch of this stuff written out so you can take a look at those. We’ll want some interconnectivity with our ehr. So we have three ehrs. So we’ll need something where we can do, you know, API connectivity to push and pull information or something like that. Makes sense. We’re about to implement visiquate… and I don’t know if you’re familiar with it, but visiquate is a revenue cycle management services platform… workflow and analytics platforms. So what it’ll do is it’ll take your eight 30, five, eight 37 and all of your patient data and start telling, you know, sort of all that root cause of denials, helping you look at how, you know, how do you service up? What you need to collect next? What’s your priorities for collection? It’d be interesting to see is if there’s some sort of like interplay there, they don’t do anything with credentialing, right? And so, it’d be really interesting to see if there’s something there that’s an interesting play and if not, that’s okay too, but it might be interesting to see. Is there, you know, a future of where those things could talk to each other, maybe? Oh.
Bradley Eral (17:11) Yeah, that’d be a, I think a very compelling integration for sure for all the obvious reasons.
Karen Baker (17:17) Let’s see. So we use Salesforce as our service cloud for our ticketing system and support for our customers. Yep. So it would be great to have an API with Salesforce and obviously, that’s totally possible, right? But that’s just would be on the list of things that would be great to have. So that we could, if our customer has a question, right? They could submit it through there and it could service up and we can do an integration back to your credentialing platform.
Joshua Levitan (17:45) So that’s more for support the Salesforce piece you were just mentioning. So.
Karen Baker (17:49) That’s for our customer support, right? So that’s how our customers submit tickets for application support. And if we wanted to run our credentialing follow up questions and things like that through there, that might be interesting.
Joshua Levitan (18:03) Okay. Yeah, that’s what I.
Karen Baker (18:04) Was asking like what makes sense? But that’s just on the list.
Joshua Levitan (18:07) Yeah, no, that’s what I was asking. I think there’s an interesting concept here that we’ll certainly get into more. But I just want to pause on that point because there’s like support like, hey, I need help with, you know, I don’t know the tool is not working. What’s taking so long? I have a question. And then there’s like what we would consider outreach that’s like more ticketing based on like, hey, we need this document or we can’t submit your enrollment?
Karen Baker (18:27) Yeah, right. Right.
Joshua Levitan (18:29) Which is like sometimes more of like a in platform type of like workflow notification, moving you through the process than a support issue. Yeah. So.
Karen Baker (18:40) I don’t want to break your in platform workflow logic to just throw something over Salesforce, right? So, this was more of like, is there an extensibility into something where our customer who’s already gone through that initial stage of their initial credentialing, their ongoing customer? They have, new provider needs to get credentialed. Could they submit a ticket in Salesforce from our, through our support queue? We route it appropriately and could that come to your door and trigger something on your side? I think that’s more of our intention.
Joshua Levitan (19:12) There. Got it. Okay. Thanks for the clarification.
Karen Baker (19:15) Yeah. I’m going to send you, we have some, there’s some expectations… around… some standards that we’re going to need. I mean, obviously hipaa compliant and things like that, but we need specifically… I think the acronym I’m looking for is… not popping on my screen right now. Oh, caqh… it’s one of our, yeah. So you’re familiar with that great?
Joshua Levitan (19:49) Of course. Yeah.
Karen Baker (19:50) Okay. And then if you want some quick metrics of the size today, we have a distinct count of active providers of 841 and… a distinct count of locations of 88. Sorry. What do you, what do you mean? 841? Is that like clinicians or yep provider? No, of providers, not clinicians, providers, healthcare organizations. You mean yep, locations that are submitting for credentialing?
Joshua Levitan (20:25) Wait, yeah. Okay. Let’s let’s just define that going forward because we consider a provider like a therapist. So by provider, you mean a business or?
Karen Baker (20:34) A clinic site. No, 841 is a therapist. Okay. Gotcha. Now, that makes sense. And then we have, and then we have some inactive, but 841 are active.
Bradley Eral (20:46) Okay… perfect.
Joshua Levitan (20:51) And, and then this?
Bradley Eral (20:53) Is all really great by the way I appreciate it. So let me just read back what I’ve heard thus far. I want to make sure I understand things correctly. So it really sounds like at the core of this, there’s a lack of automation with the current process and of course, like the ability to have escalation management within platform. But ultimately, it sounds like this is leading to potential delays, denials and your team’s left with all the downstream implications that come from it where your customers aren’t blaming you for poor credentialing but they are blaming qualifacts for denials, right? Hey, you manage our rep cycle. Why is this still taking place? They expect the easy button, not knowing oftentimes like root causes potentially work they’re doing on the front end of this, right? And then it sounds like, of course, like across the board, a modern platform with, of course, an open API is going to be vital just by nature of all the, you know, three ehrs, Salesforce by the gate, like all the integrations that’ll be part of this, but I’m curious like as you look at the process today, I know lack of automation is a huge part of this, but where are things breaking… the collection of data? Is it the submission of data? Is it your team following up with the payers? Like I’d be curious if you were to pinpoint kind of, hey, what are we trying to solve here? If any of those jump out?
Karen Baker (22:07) I mean, it’s probably all three of those that’s a great question. I have a whole team that would be able to sort of come forward and this is to me like a meeting for a meeting, right? Yeah, exactly. So they would be able to answer some of those real pain points. I mean, I’m sure. All three of those are pain points.
Bradley Eral (22:28) Yeah, but it makes sense. And then, is it, so I’m sure all those are pain points. But then the output being, when you’re seeing denials, is it inaccuracies? Is it, the process is just taking simply too long? So you have your customers delivering care before they’re actually a network for sure?
Karen Baker (22:46) We have that. So then we have situations where they don’t want to wait, you know, there’s too much demand for their services. They go ahead and they perform the service and then the claim is going to get denied, right? And so then we have to go back and help them with an appeal or whatever the process is to sort of support the fact that, you know, it should actually be covered. Makes.
Bradley Eral (23:10) Sense. Absolutely. And then the other question I had is that, so 841 providers today, and obviously, like that team of 10 that you’re fortunately by nature of your business, able to blend onshore or offshore, like oftentimes when folks come to medallion credentialing, if they do it in house ultimately becomes a cost center, right? It’s expensive to maintain. And then a very manual process. So as you scale, you just have to continually have to add headcount, like is that part of really what’s driving this is finding a more scalable option for the businesses or more? So, hey, we’re just looking to improve performance and what we’re doing today is networking.
Karen Baker (23:46) I… mean, we don’t have a great workflow solution today either. So it’s not that it’s an expensive team. Yeah, it’s not that large a team, right? So, the rest of the rcms is a significantly larger group of people. Yeah, I have 250 people and the rest of rcms and it’s only a fraction of them on credentialing. So it’s not that it’s an expensive solution at all. It’s more that we need something scalable because we are now starting to include it in our bundle in the, in our pricing. And so now we’re getting more and more… you know, sales commitments for us to deliver credentialing, and we need to be able to respond to that quickly at scale when previously it was kind of sold as an add on in the past before we rolled out a bundling practice. And when it was sold as an add on, you know, it would kind of come in consistent, right? And so while it was complex to support the demand, it wasn’t overwhelming. Now it’s starting to get to where, we can’t scale for it.
Bradley Eral (24:53) Gotcha. Okay. That makes sense that.
Joshua Levitan (24:55) 800?
Karen Baker (24:55) Must.
Joshua Levitan (24:57) be, I mean single digits penetration of your overall user base in terms of people using credentialing, I would imagine.
Karen Baker (25:05) Right. Yeah, yeah.
Nicholas Chepesiuk (25:06) That’s what I was still confused by Karen. So, yeah. So, so you mean literally like 800, only 800 actual users, ehr, provider users currently… leverage our credentialing, yeah.
Karen Baker (25:24) It’s, it has historically been really low, right?
Joshua Levitan (25:28) That’s less than one percent, I would imagine, right?
Nicholas Chepesiuk (25:31) Yeah. We’re like in the 100,000, yeah.
Karen Baker (25:33) That’s right. If you look at our line item necklace in the PL of how much is specific only to credentialing, it’s really small. And now we are selling it in almost every bundle. So, imagine going from a team that was supporting something that small. Yeah, now being included in every bundle and some of them are bringing on 12 or 14 providers at their practice a month. You know, they’re bringing them on so quickly that we definitely don’t have the scale to support.
Joshua Levitan (26:02) Yeah. So you could end up credentialing hypothetically 15,000 providers next year and you’re doing 800, right?
Karen Baker (26:07) Now that’s right, in theory, right? And so, yeah, we’re not scaled for that at.
Joshua Levitan (26:13) All, what about upsell within the current customer base?
Karen Baker (26:16) Yeah. I mean, for sure. There’s lots of things we could upsell.
Karen Baker (26:19) I’m always nervous of all that opportunity when I don’t have all the scalable solutions underneath it. Sure. So I’m trying to like over here on the side eyed a.
Bradley Eral (26:28) Little bit, yeah, before.
Karen Baker (26:30) They start figuring out they could start doing too much more upselling of it into our existing base. Of course, there’s a huge amount of opportunity to do that.
Joshua Levitan (26:38) Okay. That makes sense exactly. And.
Bradley Eral (26:39) Then let me ask you this. How familiar are you with medallion? If at all?
Karen Baker (26:44) I’m not personally, that familiar. I don’t know how familiar Nicholas is. Other than the fact that he had, he happened to have the email, but I’m not that familiar perfect.
Bradley Eral (26:54) I can give you the 30,000 foot overview. So essentially, if you look at credentialing historically, there’s kind of two ways to solve it. It’s way, one is what you’ve done as far as purchase the software, build out an internal team, maybe some onshore, maybe some offshore. But the challenge is, you know, modern software, they’re essentially task management tools. As far as credentialing goes, you’re still left with a very manual broken process ultimately that isn’t necessarily scalable and also is prone to errors. And then on the alternative side, you can outsource this entirely which is essentially just taking that manual process, throwing it over the fence. And they’re still we tried.
Karen Baker (27:30) that we brought it back exactly.
Bradley Eral (27:32) So you’re just taking a broken process, moving it elsewhere. And now you just don’t have visibility into what’s broken, right? It becomes a black box. So what medallion’s done is we’ve solved this fundamentally different than anyone else out there where we’ve built a solution from the ground up over the last, what five years now where we’ve taken an automation and AI first approach to every step of the enrollment process, where we’re going to automate what we absolutely like everything we can. There’s going to be certain things that you just can’t automate in enrollment, whether it be from a compliance or pair specific standpoint. So, we also have a team of, you know, experts that sit behind the scenes. But this blend of, you know, people and technology. Ultimately, what it does is the output to our customers is we contractually commit to how fast this work is done via an SLA that actually has teeth behind it where if we miss our slas, there’s financial ramifications for us. So essentially like you get burned, we get burned, we need to be an extension of your team and this structure. Ultimately, I’ll use the ehr example. Why many of our ehr partners like this is it becomes essentially standards that they can really under their customer base and credentialing becomes a point of differentiation opposed to a point of friction. And then from the rev cycle standpoint, of course, you know, that we’re going to deliver on these slas, and from a denial perspective, they’ll still be denials of course. But credentialing won’t be the root cause of those denials. We’re going to take those denials off the plate and have this be something that frankly, you never hear about it’s. Just a well oiled machine. So, and then the last thing I’ll say is, you know, ultimately, if you look at kind of this approach because there’s so much automation is the scalability factor is we, we’ve reached thresholds that we haven’t seen anywhere else in the market. We have customers with upwards of 200,000 providers and, you know, customers of, you know, much smaller than as well, but it allows you to know like, you know, to your point, you’ve been kind of holding things back because you don’t know if you’re ready to throw this at the whole business. Essentially, medallion reacts as a utility scale up and down as needed, right? So I’ll pause there. Quick. I’m curious like first off, what questions do you have on that at a very high level? So.
Karen Baker (29:41) Behavioral health specific is that a piece of your what like, where is sort of your sweet spot, of your mix of yeah type of business that you work with?
Bradley Eral (29:54) We work with all provider types, behavioral health being, you know, one of the more frequent ones actually because we initially we were founded like the Genesis of covid, when everything was going remote and we’re doing multi state licensing as all these therapists were doing, you know, telehealth. So, yes, behavioral health, I’d say one of our strongest verticals.
Joshua Levitan (30:12) It is by numbers. I actually looked at this recently. It is by percent of providers we support the largest and specifically within these type of partnerships with the HR rcms, also by percent is the largest by a substantial margin. Okay?
Karen Baker (30:29) Okay. So you do sort of both types of service? Where if we wanted to just buy your technology and we are the hands and feet that do it, and then you also offer an extension, of outsourcing or some sort of hybrid type of approach of that or is it just, so?
Bradley Eral (30:43) Essentially, imagine us as an MSP, right? So, there’s no option with medallion where you can just purchase a software and have your team run things out of medallion. Your team will still have visibility in the platform, right? And be able to like dictate, you know, when things take place. But we’re going to do all the blocking and tackling of credentialing as far as filling out the application, submitting application, following up with payers. So the ultimate goal is let’s free up your team’s capacity for frankly more valuable work with your customer base opposed to again the blocking tackling of credentialing but I do want to be clear on that point because especially you kind of mentioned like, hey, today’s a meeting for the sake or like I mean to see if we should have another meeting, oftentimes credentialing teams directly like leadership, very high end values or medallions proposition. But the team directly is oftentimes threatened because ultimately, what we’re positioning is a way to do this work better faster and cheaper than anyone can do in house. So it’s kind of a different way. Obviously, I’m preaching to the choir, given your guys’ business model, they’re quite familiar with that. But I want to be clear as far as like what medallion would entail. And if kind of as you view this, if that’s an option, right? Or are you looking strictly for software only to support the?
Karen Baker (31:55) Team. No, I actually was pushing for this option. So this is interesting. So I’d like to keep you in the mix of the other ones we’re evaluating. We are looking at some, I believe some software only options as well, but I’d like to keep it in the mix so that we sort of have that point of view and see which one sounds like it would work better for us. Our.
Joshua Levitan (32:15) Philosophy is like the software only, it’s glorified task management. You’re talking about scaling right? From, you know, we threw around the numbers of 800 to 15,000. I think like sometimes the way that we describe our.
Bradley Eral (32:29) approach.
Joshua Levitan (32:30) to this industry is in many ways like we’re a utility like we’re the power grid, you don’t have to staff up to support those quick influxes, right? And you said you were already sort of attracted to this option. So, I’m sure these are the things that you’ve already thought about, right? But like you don’t have to staff up to support those quick influxes, like you draw from the power grid, that is medallion as much power as you need when you need it. You know, maybe I’ll use an analogy. You’re a brand new AI data center that just got built and you need to hit the grid heavy like we’re the grid that can support that more cyclical things, right? There’s a time where there’s less providers joining for whatever reason than like a, you know, you don’t need to draw from the grid and you don’t have people that are being paid to sit around and do nothing?
Karen Baker (33:12) Okay. So what is your typical… interaction… model? Like I said, how… do you typically deliver those services to interact with them with our team as an MSP? Do we have a like sort of a dashboard and a login and a status that we check and see how things are going. We deliver the customer to, you onboard them into your credentialing side. You start working with them quickly and giving us that feedback of as they’re going through the credentialing steps, so that we know that when we are helping them? Because I think they probably ask us to hold claims until they know that they’re credentialed, right? Like how would we kind of maintain that back and forth exchange of making sure that we’re meeting the customer’s needs from a relationship standpoint, while looking at you as an extension of our service?
Bradley Eral (34:05) Yeah, for sure. Josh, I’ll have you take this one but one confirming question or confirmation question on that, Karen, like in a perfect world, how integrated do you imagine this to be with your ehr platform? Like there’s various flavors of what this looks like. Some of our ehr partners want this to be entirely embedded and look and feel like in this case, of course, qualifacts or others want it to be more of a, you know, light integration, whether that be like sso and like, you know, some deep linking, like how do you envision that from a tech standpoint, that’ll kind of help inform what the relationship looks like?
Karen Baker (34:34) Yeah. Right now, it’s not integrated at.
Bradley Eral (34:36) All. Okay.
Karen Baker (34:38) I think that was one of the reasons that Nicholas and I were interested in thinking through this because I think from his perspective, might there be an opportunity to think about doing something that is integrated because we have customers that will want to do credentialing for themselves, right? Yeah, that will erode into our service. But our service is a lead into our revenue cycle services. We are not a credentialing shop, right? Exactly. We are a revenue cycle. We happen to offer credentialing as a hanger on, right? Yeah. What makes sense? There would be interesting, right? We could think through, but it might be interesting to see how we would add it as an extension into the ehr. Yeah, we have three ehrs. It might make sense to consider they’re different ones. One’s small market. The other two are enterprise size behavioral practices. So it might be a different story with small market than it is with the others? Or maybe not, right? So it might be interesting to think about it. Is it slightly different? Yeah?
Bradley Eral (35:38) It makes sense. And obviously, as conversations continue, we can really dig deeper. But josh, regardless of integration level, I’ll have you speak to kind of like operationally, what have we seen as far as best practices with our RCM and ehr?
Joshua Levitan (35:51) Yeah. I mean Karen, I think you almost took the words exactly out of my mouth which is, I think for you here, there’s probably actually two models at play and they’re different between your different ehrs. So first as a blanket statement, we’re really flexible, there’s different ways we can run this. What we think works best and what we’ve seen works best. And what we know gets the best results from peers of yours specifically on the small market side is like truly this being integrated, right? So if you think about medallion, like you make a request, say get me credentialed with this payer. We take your information. We submit that with AI, we follow up with AI, we track status. We tell you when you’re par, right? Like that request can happen in your tool… reporting on the process can happen in your tool and you’re now creating more valuable action natively in your platform. That is like, I think it’s the gold standard on let’s call it like probably sub 15, maybe sub 10 provider shops. And so that’s sort of like the full integration method. Now, there’s obviously a lot of development work that comes into play there. And like a lot of that quite frankly falls on you. Like there’s new UI that you need to build there. So with a lot of our partners, like we don’t always start there a lot of times where we start, we’re like, you know, phase one, you’re being pushed into medallion but, you know, you’re there’s sort of like an sso situation, right? So you come right over so you don’t have to deal with dual logins but it feels and it’s branded like an extension. You’re just on a different URL and we push back at first just or push and pull just like very basic data information, not only to help get the sort of provider’s data profile built out. But then also to your point like parse status with this payer on this date to drop claims. And we then build towards like the full, like there is now a new module in your tool that the provider is going into and they are never going to medallion. I think with the bigger practices, this is where it varies with the bigger practices, like they often have someone who is like their full time job or half of their job is credentialing. And so there’s a little bit more basically.
Joshua Levitan (38:02) I guess the best way to say is you’d have to build a lot more to replicate medallion in your tool for those users and that doesn’t make sense because our tool was created for those users, right? So in that situation, we definitely want a good level of integration because you’re going to have data that we need. So why make them type it in twice? And we’re definitely going to want to push back information again par, effective date to drop claims. But that might be a situation where the user is actually in… medallion more frequently operating as a practice admin credentialing manager. And we’ll call that definitely a 50 plus provider clinic. I think there is quite frankly some variability between that like say 15 provider and 50 provider mark and it depends on the maturity of the business and that’s certainly something I imagine we will have a lot of fun conversations about down the line. But high level, I think that’s the bucket of how we see this work best.
Bradley Eral (39:02) Yeah. And in a follow up session, what we can do is walk through in detail essentially what’s the, what will medallion be doing in the relationship? What do we recommend that your team do in the relationship? And what will your customers own? I think they’ll add a lot of clarity into like, okay, how do you actually operationalize this, right? But I’m curious as you look at kind of your segments, you mentioned that, you know, you got the small practice groups and I heard, I guess how do you kind of bifurcate between practice sizes in your eyes? Between small, medium and large, if that’s how you nominate them?
Karen Baker (39:34) Yeah, we actually split them based on I’m.
Joshua Levitan (39:40) Going to have to pull up exactly.
Karen Baker (39:42) The split, but we do split them based on, we can split them by either provider quantity. And that’s how it sort of determines what package we offer them if they’re coming on as a new customer? And then our existing customers, we do split them based on the way their revenue splits. But I was trying to see if… I have something that I can quickly tell you that’s split without, no, I don’t have it right here, but that we do bifurcate them based on the size of therapy practice. I mean, the size of the therapist at the practice?
Bradley Eral (40:17) Makes sense. And then obviously like broad range, I guess what does it look like on the small end and then how on the larger end? How many providers do some of your customers have?
Karen Baker (40:28) I mean, our small ones can have 10 or less. Yeah, right? So they’re very small and I’m not actually sure how many of our larger ones, we have a couple of large ones.
Joshua Levitan (40:40) Some of them have thousands, like some of the biggest like.
Karen Baker (40:45) But I would assume they have dedicated credentialing teams.
Joshua Levitan (40:48) Yeah, or quite frankly, they might already be using us, right? Like we have customers that have 5,000 therapists that use us independently of any RCM tool.
Bradley Eral (40:56) But, yeah, no, that’s a helpful perspective. And, you know, goes without saying regardless of where it is on that spectrum medallion will scale, we have customers, you know, of all shapes and sizes.
Joshua Levitan (41:06) But one thing Brad, I just want to interrupt one thing I think that is important to mention. Like outside of the ehr space, we’re ranging from maybe 50 providers to 14,000, 15,000 in our biggest customer. But we actually don’t really entertain individual companies that come to us below a certain threshold. It’s not worth it for us, right? As you can imagine. And so, one thing we have found with our ehr partners that’s like really beneficial is your value prop to your mid size and to your smalls is like you can’t go and get this service on your own, right? And it makes you that much more valuable to them because you are unlocking the ability for them to get best in breed enterprise software that they, we would turn them away if they called us, right, right?
Bradley Eral (41:57) So, let’s do this. I want to be mindful of your time based on what I’m hearing, I think there is alignment and it’ll give you a nice breakdown of as you evaluate software options, like what it would look like if you solved it the medallion way, as far as, you know, let’s just call it an MSP model for argument’s sake. But I recommend we set up a follow up session where we can again walk through kind of the operational model, show you a light demo just to give you an idea of what visibility will you have? What visibility will your customers have? And like ultimately put you in a spot coming away from that discussion.
Bradley Eral (42:25) Hey, technically and operationally, does it feel like there’s still alignment based on what you see in that session? Does that sound like a good next step in your eyes? Yeah, it does perfect. Let’s see, we got 15 minutes left. We can schedule that live line right now. If that works, I can spare you from some back and forth.
Bradley Eral (42:49) And I’m looking probably… the week of April sixth. Okay. Let me get my others… on the call that need it. Appreciate that.
Bradley Eral (43:16) I probably don’t need to be on Karen. Yeah.
Karen Baker (43:22) If you want to talk to Eric about any other… options that you want to consider, necklace definitely let me know. Okay… thanks. If you find any, yeah, anything there that you want to further consider. Okay?
Karen Baker (43:44) Let’s see… can six?
Karen Baker (43:54) Ooh, I got a, I got a sweet spot on Thursday, April ninth at 10 a. M. I mean, nine a. M eastern. I’m Eastern Time. Sorry, I don’t know. Does that make any sense? Yeah.
Bradley Eral (44:05) You said nine a. M. Eastern. Did I hear that nine?
Karen Baker (44:08) A M eastern on the ninth? Yeah.
Bradley Eral (44:10) That’s perfect. I’ll send over an invite. We’ll block out an hour. That should be more than enough time and we’ll use that again, walk through the operational model, walk through the demo and field some questions.
Karen Baker (44:23) Perfect. Amazing.
Bradley Eral (44:25) So, I’ll send that over and then in parallel, I’ll send this a document.
Bradley Eral (44:31) It’s probably time to like as fill out. But ultimately, we can get an idea of like sizing because what we can show you is we’ve replaced in house teams at hundreds of organizations at this point can give you an idea. Hey based on your expected volume, what would this look like to build out internally from a staffing perspective? Obviously, you have a good idea of building that today, but I think it will help frame up as you look at the builders by mentality like what makes sense from a business perspective? Yeah, cool. Great. Awesome. Well, thanks so much guys. Looking forward to the ninth all.
Karen Baker (45:00) Right. Thank you. Bye.
Bradley Eral (45:00) I’m going bye.