Transcript
Bijon Brydson (03:15) hey, Steven.
Steven Scott (03:18) Whoa. Do you hear me?
Bijon Brydson (03:20) Yes, sir. How you doing? Great.
Steven Scott (03:22) Good. Nice to meet you.
Bijon Brydson (03:24) Nice to meet you as well. Happy Thursday.
Steven Scott (03:27) Happy Thursday.
Bijon Brydson (03:29) Awesome. I want to go ahead and kick off introductions and kind of introduce the team on our side and as well as obviously give you a chance to introduce yourself. My name is Bijan brightson. I am the client executive that covers vitalcaring based in Tampa, Florida had a chance to meet Chris for lunch and a little bit late last year like around the August September time frame. He told me that things were kind of changing that you were going to be in play, came into the mix, kind of told us a little bit about what you guys were doing currently from a credentialing standpoint, but obviously, he said he wasn’t deep in the weeds. So he wanted to get us integrated. And to my right, she’s actually at a wework, but I’ll introduce her. Her name is Mallory smith. She is my technical counterpart. She’s based in Nashville. So relatively closer to you than I am. So we are the two person tandem that covers vitalcaring.
Mallory Smith (04:32) Yes, it’s nice to meet you. I apologize for the wind. I came to a wework without headphones today. So now I’m sitting outside where there’s nowhere else. And now I’m just like what is this Nicholas sparks? Like what is going on? My apologies.
Steven Scott (04:49) That’s great. Where are you located for this meeting?
Mallory Smith (04:55) I’m in Nashville, Tennessee at the wework on the.
Steven Scott (04:58) Okay, great. What is wework? Wework?
Mallory Smith (05:03) No great question. So wework is like this communal office based building. So, whenever covid happened, everyone had to go work fully remote. Well, this company thrived. So it’s basically just like a huge building that companies from all across the nation really or world can rent and they can have specific memberships and their remote employees have an option to go work remotely. So inside, we have desks and rooms and phone booths and things like that. All the phone booths were booked and I forgot my headphones so that’s why we’re outside. It’s okay. But it’s really nice. It’s just a place for people that are like normally fully remote to come together like meetings, weekly, things like that.
Steven Scott (05:42) Yeah, I love it. That’s great. Okay. Well, very nice. Nice to meet you. It’s nice to meet you.
Bijon Brydson (05:49) Awesome. If you’d like to introduce yourself, Steven, that’d be great.
Steven Scott (05:52) Sure. Steven and I joined vitalcaring group January the 20 ninth or so. Chris and I have been in conversations for the last couple of years.
Steven Scott (06:05) Actually, I was at capacis for about eight years which is over there in Brentwood Mallory. So I was there for a number of years. They’ve had a number of acquisitions and I exited there around… goodness October 24. I believe, yes. So I had a one year non compete.
Steven Scott (06:34) So I went and did a couple of different things and dabbled in different ventures and just learned during that year how much I love the post acute space. So before that, I was with healthy living at home based in the bay area. Nice for many years. So you said you’re in Florida, but I see the bay bridge. So, you know?
Bijon Brydson (06:57) Yeah. So funny thing is we’re headquartered in San Francisco. Okay, great. We just had a pretty much a off site there and I got a chance to see this bridge man and I’m like, all right, this is cool. It’s going to be my background. So that’s kind of what happened.
Steven Scott (07:16) That’s great. Yeah. I spent a number of years living out there, yeah, out in the bay area for… well, funny enough, I went to the air force and in the air. Force. I was up in the Sacramento area. So I’ve really been in the bay. I was in the bay area for probably close to almost 18 years. Wow. So it’s my backyard.
Bijon Brydson (07:40) That’s awesome. Well, no, I appreciate you taking the time. I always like to leave with this question. What made Chris, have you talk to us today? Like what’s kind of happening inside the vitalcaring school? Yeah.
Steven Scott (07:54) So we’ve had a number of acquisitions and I think before I was here and before our acquisition, there was a number of different opportunities and staffing challenges… that… we’ve got a number of different areas like we’ve got a group that does our billing for palliative, and they’re also doing our credentialing, and then we… restructured a little bit recently about a month ago. So all licensing and credentialing moved back under revcycle under my purview. So I’ve got a couple of people in the seats, but we, you know, we’re still trying to get organized. You know, we’re behind. We’ve got some credentialing opportunity and some needs to get more organized with it. And so, you know, wanted to engage and just chat with you all to see what type of service offering you all have and what type of support is available.
Bijon Brydson (09:01) Awesome. Well, yes, appreciate you. Appreciate you connecting and obviously thank Chris for connecting the dots. Happy to dive in and I.
Steven Scott (09:11) need a basketball hoop by the way. So if you can send me one of those basketball hoops that’d be great.
Bijon Brydson (09:17) Yes. I actually, I have to reach out to marketing but I’ll try to get you one for sure.
Steven Scott (09:24) Actually, I think we’re going to hang it up in his office so that we can go in there and shoot hoops while we’re chatting.
Bijon Brydson (09:30) There you go. There you go. That’s awesome. Well before we kind of dive into medallion. I do have a couple of questions just to learn a little bit about what’s happening in your purview and just kind of get a better understanding of like, you know, the process in itself. So, how are you guys? I know from just going off of what have Chris has told me you guys are doing enrollment and potentially credentialing at the facility level? I know you guys don’t manage physicians today, but what is that process? Like the credentialing process look like?
Steven Scott (10:02) Yeah. So for credentialing, palliative, the nurse practitioners and the physicians are credentialed to our groups. So for palliative care, there are groups for home health and hospice, there’s practitioners don’t excuse me.
Bijon Brydson (10:20) Bless you.
Steven Scott (10:23) Excuse me. Sorry. Yeah. So there’s not any physicians or RNS… or nurse practitioners, or physical therapists that get credentialed. We’re not a part B shop. So we’re not part B outpatient where the therapists have to get credentialed. We just have what I would call facility credentialing. We don’t have to get any clinicians or practitioners associated to our facilities. So it’s pretty straightforward, pretty simple process quite frankly.
Bijon Brydson (11:01) Okay. And how many, what does the process look like today from a management perspective? Like how many people on your team are managing this process today?
Steven Scott (11:10) So, it’s a very small group. We’ve got basically one and a half people doing credentialing and then we have one person doing what I call licensure with the state and CMS, okay? And,
Bijon Brydson (11:24) on the palliative care side, how many new NPS and physicians are you enrolling?
Steven Scott (11:30) Very small, very small. Yeah, I’d say probably less than 20 and.
Bijon Brydson (11:35) Then on the home, when you say 20 20 in a year, correct? Yeah. Okay. And how many payers is those? Is those physicians being enrolled with usually on like,
Steven Scott (11:49) a, oh, just a couple, we have palliative only in one state. So there’s I’d say probably three to five payers.
Bijon Brydson (11:56) Got it. And then the home health side seems like there’s that is where a lot of the pain is coming from. Talk to me a little bit about the process of enrollment there. Like where are the delays that you’re seeing some of the pain from? Like where is it happening in the process? Yeah.
Steven Scott (12:13) So, I mean, we don’t have an organized systematic like portal to where we know when credentialing is expiring. So we’re in a bit of a reactive state. We’re getting letters there’s. You know, letters sometimes are getting misrouted and so probably… a little bit more of a proactive versus reactive is of interest to understand when credentialing is expiring, you know, understanding when, you know, we should send our new license to the payers, right? Versus them having to ask us because we don’t want to have, you know, claims go unpaid because the credentialing has expired or there’s a missing document or expired state license kind of thing. So, looking for some, you know, organizational structure in that regard, whether we do it internally or, you know, engage a partner to support us with that.
Bijon Brydson (13:05) Got it. Mal. I know you had a question.
Mallory Smith (13:09) Yes, I did. Thanks. So, Steven, just a quick question. So you first, you mentioned you’re getting letters and understand being proactive rather than reactive. Are those letters coming from payers regarding the credentialing? Okay. So when we think facility credentialing, there is facility credentialing, where we’re credentialing the actual facility to aaahc standards. We’re having to verify all the things at facility level. There’s. Also facility credentialing, what we call facility enrollment, where we submit the facility applications to payers, we’ve managed that relationship, we track revalidations, which one are we talking about here?
Steven Scott (13:44) Facility? Okay.
Mallory Smith (13:46) So the facility with payers, facility enrollment, getting those letters? Okay, thank you.
Bijon Brydson (13:53) Got it. Awesome. And then you mentioned you have a, could you talk to me a little bit about what your footprint looks like? And obviously it goes, you guys are going through a lot of mergers today. So, how many new facilities are you guys forecasting within the next year? And with how many you have today? Oh.
Steven Scott (14:10) I’m not sure. Yeah, I don’t know. I don’t know what we’re we don’t really have a forecast for acquisitions. It could be small. It could be one, it could be 100, okay? And,
Bijon Brydson (14:23) how many facilities do you guys currently have today that you’re managing?
Steven Scott (14:36) Roughly 50 60.
Bijon Brydson (14:38) Okay. And last question before I kind of hop into medallion, and I’m sure some things will start to pop up, how many payers are you? Is it still that same small, you know, three to four payers that you’re enrolling those facilities with, or is it a much larger subset?
Steven Scott (14:54) Much larger?
Bijon Brydson (14:55) Okay. On average, how many payers are you all enrolling with?
Steven Scott (15:00) 15, 20. Got it. Okay. Awesome.
Bijon Brydson (15:04) I am going to share my screen and I am going to talk a little bit about medallion and I’m sure as we hop into it, more questions and things will likely pop up but I want to start with what is medallion? We are an end to end provider data management platform. So what we do is we manage the life cycle of credentialing whether it’s on the physician side or in your case, for facility enrollment from beginning to end in continuous. And we do it in a manner where you have a single source of truth. So you have one platform that showcases all your facilities as well as all your physicians all in one. So you can manage and track expirables which is very important to you as well as seeing the life cycle of that facility or that physician as they transition through the enrollment time period. We do that with slas that we govern by. So we have slas that are built in to our msa, our managed service agreement for the payr enrollment side. We have a 10 day request of submission. So let’s say, Steven Bijon, brightson, and one of your MPS as an example or facility, as an example, you request for, you know, me, my information to get sent to blue cross blue shield from the time you request, you have a 10 day SLA, that medallion stands behind to where we will get that information sent to that payr, we’re doing it on average of five days today. So when it comes to time to revenue which is obviously very important to you and Chris as well, that time to revenue component becomes, very critical and it allows you to be able to forecast revenue more accurately as you start to think about mergers and acquisitions, right? As you guys are starting to think about scale and growth.
Bijon Brydson (16:55) And even on an aspect of do we need to continue to scale the team or not scale the team? And I’ll get into some of those things as we continue to go on, we have over 400 customers today. So anywhere from payers all the way to other home health and hospital organizations across and in health systems, we operate pretty much in every single vertical you could think of across health care… going over to the next slide. I like to talk about this a lot because there’s organizations come to us across three different ways, right? They’re looking to accomplish one of these three things, if not all three, when they think about why they’re choosing medallion. The first one is to accelerate revenue just from conversations with Chris, as well as learning a little bit about, you know, what you’re looking to accomplish just in the little conversation we’ve had accelerating revenue is likely important with medallion, a lot of organizations are speeding up the time to revenue using automation using our AI that we have as well as eliminating future claim denials that you have within the process of completing that credentialing application. I would assume, you know, basically, you know, with you guys being more reactive than proactive there’s probably, you know, claim denials that are happening due to errors being that you’re getting letters from payers. I’m sure there’s some things in there that may slip through the cracks which is okay. But using a solution like medallion, we aim to reduce those claim denials that you’re seeing due to credentialing errors. Organizations also come to us in one of three scopes as I like to call it. They come to us in the beginning when they haven’t fully grown out their team. They’re starting to scale and they’re like, hey, we have a good subset of folks today that we want to continue to up level and want them to be more strategic on the credentialing side. And we do not want to add more headcount, we want to partner with an organization like medallion to help automate a lot of those mundane tasks. And then we can have those folks go upstream. We also have organizations on the other side of the spectrum. I think you guys are probably the first one that I just mentioned just based on conversations from Chris and then obviously learning more about yourself. There’s also organizations on the other side of the spectrum where they went through this whole cycle. They have software that they’ve purchased. They built this huge in house team. They realize that they’re very top heavy and they want to reduce opex, right? Because they’re like, hey, we don’t have any slas that are governing any of the things that we’re looking to achieve when it comes to increasing our time to revenue, it’s taking a very long time to either onboard that provider or gather that data in order to be sent to that payor, and we don’t have any visibility into the process from start to finish, even as we continue to go through the revalidation process. So we want to repurpose some of those team members or reduce opex, just being completely transparent with you, right? So some organizations come to us on either side of the spectrum and that’s where we come in from a reduced operational situation. So either preventing future opex, or reducing current opex is where organizations come to us on the spectrum. And then the most important one that I think matters the most. Is removing provider abrasion? So using a world class platform like medallion, you take a lot of the clunkiness out of, you know, the provider experience. So not having to fill out 46 to 50 pages of paperwork when you’re trying to onboard a provider and get them build faster, but being able to use technology to make the process fun almost like when you go to a restaurant and you use a barcode to scan to get some food. We have that same experience here at medallion also as well as from the organization side, speeding up the time to bill. So just like yourself or just like myself, if I was a provider and I am excited to work with vitalcaring. I want to start working as fast as possible. So being able to be able to work with an organization that can help your providers get billable faster or help the facilities get billable faster so that the organization can start to make money, is how we’re helping organizations like yourself remove provider abrasion. Last one, I want to show, this just kind of highlights everything we do at medallion. So I like to look at this as like a big rainbow. So we handle provider data management. We are a provider data management platform. We also have the ability to perform monitoring. So, a lot of those sanction checks, npdbs, we do it all. We also have the ability to do direct payer enrollments. So we handle not only payer enrollments for the physician, but also for the facility as well. We work with every payer you can think of across all pra.
Steven Scott (21:39) And eft… mal.
Mallory Smith (21:43) We will do that if it’s a part of the credentialing application itself. Yeah.
Bijon Brydson (21:49) We also are a cvo, so we have the ability to manage rosters when it comes to delegation. So when you think about time and revenue, we have an SLA for that, and.
Steven Scott (21:59) Our providers can fall into that.
Bijon Brydson (22:03) Correct. Mal, I’ll let you kind of touch base on the delegation stuff. I don’t want to overstep.
Steven Scott (22:09) No, of course. We.
Mallory Smith (22:11) Just have some of the caqh aspects.
Steven Scott (22:13) Yes, for.
Bijon Brydson (22:14) Delegation. Sorry, yeah.
Steven Scott (22:16) So, I’ve got experience when I was letting my non compete burn out. I was supporting a pretty big orthopod group across multiple states which included the Stedman clinic. And we struggled with… I also supported a fertility group and it was pretty unfortunate because there would be clinicians that would have to wait to provide services to certain payers, because we were waiting for the credentialing to approve. And we didn’t have any sort of delegated authority because it’s challenging and there’s a number of different things you have to do to become a delegated provider. And so we would often find ourselves losing volume because a physician couldn’t see patients under certain payers, or similarly, if we had new orthopedic surgeons, they wouldn’t be able to care for patients because we were waiting on the silly credentialing. So similarly for us in palliative care, you know, my assumption is we go through that, you know, today. And so are you saying as soon as we hire a nurse practitioner, you guys, if you’re a delegated provider… then you could get that nurse practitioner added to our group within days or you have to wait for the payer to approve it?
Mallory Smith (23:45) No, I appreciate the additional context there. So.
Steven Scott (23:49) If we.
Mallory Smith (23:50) enter into a delegated credentialing arrangement, we are an ncqa certified cbo. So we have the ability of credentialing your providers through the three day turnaround time, and then we would add them to a roster. There are of course, stipulations where you have to have a certain provider volume a minimum. And then there are certain specialties, certain payers such as government payers, medicare medicaid, that don’t allow for it. But if you are interested in accelerating revenue, considering delegations, we could just send you a few questions after the call regarding some of those restrictions from payers and then be able to give you a more accurate answer there. But yes, that is the ultimate goal because we are a cbo ncqa certified. We can credential those providers in three days and have them billing within 30.
Steven Scott (24:34) Okay, great.
Bijon Brydson (24:36) Absolutely. And then just some of the other things we do as well. We have the ability to perform privileging. So, for some of those MPS and I would doubt that this would happen with the sheer amount of locations that you guys have. But let’s say they perform, you need to give them privileges to other hospitals outside of your network. We have the ability to do that as well. And then from a state licensing standpoint, we do manage renewals. We do apply for state licenses as well as handle Dea csrs et cetera. As you think about licensing as a whole… I threw a lot at you just want to hear if you have any questions, thoughts feedback as you think about like what you’ve heard surrounding medallion. So.
Steven Scott (25:25) As part of the credentialing process, we could add in the eft as well for the ach process. So.
Mallory Smith (25:34) If the credentialing application as a part of getting provider credentialed, it is required to have the eft or era be a part of that, then, yes, if it is a completely separate application process, it’s not on the same paper. It’s not a requirement of the payer, then we wouldn’t handle those.
Steven Scott (25:52) Okay. Understood.
Mallory Smith (25:54) I think it’s going to be very payer specific. I would be more than happy to take your payer list back internally to our operations team and find out which ones they are required versus which ones are not.
Steven Scott (26:04) Okay, great.
Bijon Brydson (26:06) Absolutely. What I would like to do, Steven, I would love to schedule some time next week where we could take some of the information that we have. We’ve learned from you as well as showing you the platform and giving you a better understanding of what this looks like. All in scope. Just some questions I have as you’re thinking about going through this evaluation. What is your timeline surrounding having something in place to make operations be more efficient? Seems like things are you want to kind of simplify things as fast as possible, but just want to get a relative timeline on what you’re thinking… you know?
Steven Scott (26:45) I’m not so sure. Okay. Yeah, we’ve got a lot of moving parts. So, you know, just exploring what our options are. Okay, that would be helpful. Okay. Yeah. Okay.
Bijon Brydson (26:59) If you don’t mind pulling up your calendar would love to schedule to see what availability you have next week, we would likely need an hour if that’s okay, sure.
Steven Scott (27:09) As long as you don’t ask me any more questions on that call?
Bijon Brydson (27:14) Will do. Yeah.
Steven Scott (27:16) If there are any specific, I,
Mallory Smith (27:17) honestly? Can’t make that guarantee? I might still ask you some questions, sorry.
Steven Scott (27:23) If there are any specific questions that you have, if you could send them to me in advance so I can make sure the call is productive.
Mallory Smith (27:31) Yeah. I think that’s a nice compromise. We can do that.
Steven Scott (27:36) Next week. I am pretty full. So next Wednesday, I’ve got 10 a M central.
Bijon Brydson (27:47) Okay.
Steven Scott (27:50) Or let’s see. Did you do?
Bijon Brydson (27:52) Afternoon on Wednesday?
Steven Scott (27:54) Afternoon on Wednesday, like?
Bijon Brydson (27:57) One P. M central, two P. M central.
Steven Scott (28:00) I could probably do something around 245.
Bijon Brydson (28:07) That’s fine. So 345 for us. Okay? No problem.
Bijon Brydson (28:19) So, what we’ll do is I will work with Mallory to craft some questions just to help us pre set to the demo. And that will also help us from an information standpoint as well. I’ll be realistic and tell you that’ll probably be like Tuesday, you’ll get those from me. Okay? Just because I’m going to the weekend and I’m out of office tomorrow, but I’ll have those to you by Tuesday and we look forward to showing you the demo and kind of conversations.
Steven Scott (28:56) Great. Look forward to it. Enjoy that, sunshine. Mallory.
Mallory Smith (29:02) I’m turning to Chris. So I’m moving away. I appreciate the flexibility. I’m normally at my desk and my home. Oh, no, you’re fine. I love it. You might get.
Steven Scott (29:14) Me on a call sitting outside here soon enough.
Bijon Brydson (29:18) Nice.
Steven Scott (29:19) To meet you both. Thank.
Bijon Brydson (29:21) You, Stephen. You have a good one. Okay? Have a.
Steven Scott (29:23) Good one.
Mallory Smith (29:23) Thank you.