Transcript
Dawn Willbarger (00:00) hey, how are you?
Bijon Brydson (01:54) I’m doing great. Happy Thursday. I.
Dawn Willbarger (01:57) Know where are you located at? I’m.
Bijon Brydson (02:00) Based in Tampa.
Dawn Willbarger (02:02) Okay. Well, good for you because we’re about to get a storm up here shortly. So we had a tornado.
Bijon Brydson (02:09) I’ve seen that.
Dawn Willbarger (02:10) Yeah. Just about it was on the tenth. So not too long ago, almost two weeks, a little bit over two weeks ago, and now they’re predicting one again for today.
Bijon Brydson (02:21) No, make sure you’re safe. Obviously, I hope you’re not in the eye of it. Yeah.
Dawn Willbarger (02:28) Me too. I hope it hits either before I go home or after I leave.
Bijon Brydson (02:35) Yeah. So funny enough. I’m originally from Maryland. So a lot of my family lives in the DC like prince George’s county metro. So I’m very familiar. I’ve passed through Newport quite a bit. I used to live in Raleigh. So sometimes I would go a little bit away from Richmond on my way back and check it out. So, yeah… well, appreciate you taking the call today, man would love to introduce myself and just kind of learn a little bit about what made, you know, put some time on the calendar. My name is Bijan brightson. I am the client executive that covers Riverside based in Tampa, Florida, originally from Maryland.
Bijon Brydson (03:14) I’ve been with medallion for a little bit over a year working with a lot of leaders like yourself to help improve revenue cycle, you know, increase time of revenue for the organization. And, you know, really just help make operations more simplified and more automated as you guys continue to grow and scale. Seeing you guys are opening up a new facility. So would love to learn a little bit about yourself and just kind of what made you take the call today and continue conversations from there.
Dawn Willbarger (03:41) Sure. Most definitely. So we employ right around 180 providers. Yes. Ma’am, that does not include, I think I put in there 250 and I can’t even give you the exact number because I’m not over physician services. I’m the chief operating officer in physician services reports directly to our CMO. Okay? And so he is over our staff who do our credentialing for the organization. So 250 was just kind of a rough staff. I know it’s more than that we have hospitalists on and contract with our emergency room group. So I’m sure it’s much more than what even number I gave you. But one of the things that my CEO and I’ve been talking about is how do you leverage AI as much as possible? What can AI do for us as an organization? Yes, ma’am, and so that’s really brought he, this actually came across his desk and he gave it to me. I did a little research. So I’ll tell you just a little bit of background. What we do for physician credentialing is we use verity?
Bijon Brydson (04:48) Yep.
Dawn Willbarger (04:49) And then we just recently on the payer enrollment side just this past week launched credentialstream.
Bijon Brydson (04:56) Okay. So you guys are using predstream as a service… in adjacent to your team, essentially a software service?
Dawn Willbarger (05:06) Yeah. So once somebody gets credentialed in the old world, once somebody got credentialed in the organization, it handed off to our payer enrollment coordinator and he would have to go into a disparate system re enter all their credentialing information and then submit it to payers right now that verity and credentialstream are all underneath. It’s all one umbrella. So if somebody gets credentialed in the organization, those who are part of the employee group, he’s able to send them out through credentialstream to the payers automatically. It still takes manual intervention on his part to do that, but he’s able to submit them. But then it’s the constant, no one’s going out there watching to see when the payer actually uploads them. Part of the tricky part here though is we are part of an aco. So for the aco, they have to load many of the major payers into their own system. And we only load a handful into our system. So if they enroll through the aco, they go through them, we do a handful here that we do privately. So the majority are actually going through our aco, but it still involves someone going in constantly and looking to see that the payer enrolled them or not.
Bijon Brydson (06:30) Yeah. So, sounds like we’re very familiar with credstream. So I have a couple of questions. I know time is of the essence with this call and I can go a little bit over if you can as well. But some of the things that come up to mind is sounds like you’re talking through some of the pain that you’re experiencing with using this new function? I guess the question I have is did you guys just sign a three year agreement with credstream or just something that you inherited through their merger? Or like what’s your thought process behind that?
Dawn Willbarger (07:04) Oh, we did purchase credentialstream. I don’t know the contractual agreement, let’s go back though to even credentialing of providers. Do you get into that space at all?
Bijon Brydson (07:16) Yes, that is what we do. That is our bread and butter. So.
Dawn Willbarger (07:19) Let’s start there because not knowing what they exactly do down there, it’s our, the CEO and I think they probably manually still go out to multiple databases to check… yes, to make sure they have a tax id. Have they been sanctioned? What are the red flags they go? You know, they go out and they check all their policies and see if there’s any liability cases. So how does that piece work with your software? Let’s start there?
Bijon Brydson (07:51) All right. So I’m going to share my screen which will allow my talk track to kind of make sense. So medallion we are a full end to end provider data management platform. So we handle start to finish and then continuous as you think about credentialing. So we do the primary source verifications for those physicians that come in, we handle that. We are a cvo. So we have the ability to not only, you know, perform those checks to ncqa standards, but we also have the ability to perform delegation as well. So we can manage those rosters. Sounds like you guys have some of the volumes with some of your payers where you could get delegated. We have the ability to, you know, manage those rosters from a delegation standpoint. The main difference between us and a lot of other different solutions out there is one we’re end to end. And then secondly, we have slas that govern what we do. So we have slas that are written into our contracts. For example, for payer enrollment, we have a 10 day SLA from request of submission. So let’s say, Dawn someone on your credentialing team wants to enroll Bijan Bryson with blue cross blue shield from the time they click request, we have a 10 day SLA to send that payer enrollment application to blue cross blue shield. We’re doing it in five days. And in our platform, you have the ability to visibly see every step of the process. And as you guys continue to enroll different facilities, you’re able to have everything under one umbrella. So think of one single source of truth where you can manage Riverside healthcare completely with reporting capabilities as well as, you know, being able to connect the dots in the entire organization across provider data management. We do comprehensive monitoring for mpdb. All of those sanctioning bodies we handle payer enrollments which I spoke about. We are a cbo, so we can do delegation. We also have the ability to perform privileging as well. So if you have some of those physicians that are working at facilities outside of the Riverside healthcare network, we have the ability to do that. Can.
Dawn Willbarger (10:01) we pause right there. So are you saying you take the place of our current physician service department who does it from the time we launch an application, you provide that service to do it for us? Is that what you’re saying I’m kind of confused, correct? We’d be outsourcing it to you. I.
Bijon Brydson (10:21) Wouldn’t call it outsourcing it. So what I would say is this what we’re doing is we’re helping augment for example, your team that you have and help them focus on higher level tasks. So just being transparent, some organizations look at this in twofold right? Maybe you’re heavy on the opec side, right? Maybe you have too many people that are managing credentialing today, and some of those folks could focus on higher level tasks or maybe they could be repurposed in other parts of the organization, right? That’s one aspect of it. The second one is, hey, we just have simply too many people we need to reduce headcount and we want to automate some of these things. So organizations are kind of looking at us on both of those fronts. And then the third one would be, hey, we have one credentialing specialist today that’s managing this process. And we expect to grow like crazy. We don’t want to go higher, you know, X amount more folks to kind of manage this workload and still not be able to support from a time to revenue standpoint that the organization is looking, to keep up with scale and speed. So, those are the three ways that organizations essentially come to us and say, you know, these are the routes that we’re looking to go. So it’s a long winded answer to say, yes, if you know, transparently obviously at your level, if you’re thinking about, hey, how do I reduce opex and increase time to revenue, increase speed in the organization? Maybe we have X amount of folks that’s managing this process today. And instead of having X amount of folks, you really only need, you know, two or three. And we have a analytics team that actually, you know, filters in how many folks that you would need in the organization to be able to manage this process, right? So, there’s a couple different ways you can look at it.
Dawn Willbarger (11:58) It’s… been my experience from working with them. It’s typically, the delay in getting the process started is just getting a completed application from the applicant, correct?
Bijon Brydson (12:11) So,
Dawn Willbarger (12:12) it’s not necessarily that they don’t move quickly through it. They just don’t have the data. They need to do it. So, how do you close that gap?
Bijon Brydson (12:22) Correct. So, we actually have a proprietary partnership with caqh which allows us to pull 80 percent of the provider data from their chqa profile, and we also are able to bi directionally sync it back. So, let’s say you have a new position that’s starting out, you don’t have a caq, they don’t have any information inside of caqh. Once we start to gather that information, we could bi directionally sync it back to their caqh profile. So you don’t have to keep pushing and pulling when it comes to the revalidation cycles. In doing so, that’s how we’re able to get a lot of that provider data relatively quickly in the process with how streamlined it is and how user friendly it is. Obviously, I’m not able to show you the platform physically today, but I’m sure once you know earning the right to kind of move forward to that stage and showing you the platform, you’ll see how user friendly it is. And our team actually follows up with those providers as well just making sure that they’re able to get the information needed, which is how we’re able to commit to our slas that we have in place with gathering that data yeah.
Dawn Willbarger (13:24) I guess I just didn’t realize you were an outsourcing company as much as I thought you may have AI that could work directly with our current system to expedite some of the processes or emulate, yes.
Bijon Brydson (13:37) So, transparently, there are some organizations that I would say, would, you know, they have a current system today and they look at medallion as a should be completely transparent. Medallion is a replacement system for credstream, right? But there are scenarios where both can coincide, you know, together as, you know, maybe moving over all the data from credstream onto medallion, there are a lot of use cases which I’m happy to show how we’re more efficient. And, you know, how we are better just to be completely transparent and we have a lot of health systems like yourself that are, you know, coming from credstream or a lot of legacy systems and moving over to medallion and trying to find more efficient ways to, you know, automate credentialing for themselves. But I wouldn’t look at it as a, you know, an outsourcing completely. I would say, you know, we don’t want you to get rid of your staff if you don’t want to get rid of your staff, there’s ways to, there’s ways to, you know, up level them and have them focus on higher level tasks. But if there are instances where you feel like there’s an opex reduction that needs to happen, the system, you know, using AI and machine learning. And in, you know, our process, there is a play as well for yourself to be able to do so. If that’s something that you wish to do, just being transparent, okay? So.
Dawn Willbarger (15:00) I’ll let you go ahead.
Bijon Brydson (15:01) Yes, ma’am, so I’m actually going to go back a couple slides. Give me one second. I’m going to share two slides with you and then I have a three 30. So I would love to schedule some additional time with you where we can go through some deeper discovery, understand the process a little bit more. And then obviously, you know, show you the platform because I think once you see the platform and you understand how user friendly it is and solving some of the visibility gaps that you have today. As those providers are going through the process, I think, you will be very appeased with how it looks. Give me one second reshare. Okay. Can you see my screen? Yes. Awesome. So I have two slides for you. Not going to kill you by powerpoint, but just to give you a little bit of background, we are a we’ve raised 130,000,000 dollars today. We are a end to end provider data management platform. So we supply software and services, not just software. We have a little bit over 400 customers today across all different verticals. With that inside healthcare… health systems, like yourself, regional and national payers, urgent care. I mean, you name it specialty. We have customers in every single vertical you could possibly think of within healthcare. And it’s been really exciting to see all the different use cases that a lot of organizations come to us with across all the different services that I offer. Some just use us for pay enrollment, some use us for the whole suite licensing privileging, use us for delegation as well.
Bijon Brydson (16:43) Which I have to let you know that being that we are a cbo and we have the ability to manage rosters. We have a three day SLA from request to submission for those organizations that have delegation agreements. And we’re doing it on average of one day. So when you think about time to revenue, Bijan Bryson joins Riverside healthcare in 24 hours. He’s able to start being billed and that’s you know, that’s an astronomical difference when it comes to, you know, time to revenue for the organization.
Dawn Willbarger (17:16) Unfortunately, some of our Bijan, some of our contracts here that works for blue cross, yep, but that does not work for any of our medicaid plans in the state.
Bijon Brydson (17:28) Yes, I’m familiar. Yes, ma’am. Yes, I was going to say for the commercial payers, are you tend to see that if, you know, if you guys hit those volume marks, I think some payers, it’s 100 providers, but there’s obviously different specifications by state. But, you know, we have a team that’s able to help with that as if that’s something that’s of interest. And then I want to get to this slide which kind of, talks to my talk track of why organizations come to medallion. So they come to us to do one of these three things accelerate revenue which everyone cares about revenue from what it sounds like from just some of the pain that you’ve you’re explaining getting the provider’s profile filled out in a fast and timely manner is affecting time to revenue for the organization, right? Getting that, getting them through the process and then ultimately understanding where they are once their credit packet is sent to, you know, whatever payer they’re supposed to go to. So organizations come to us to accelerate revenue. I’m actually in Tampa. So this one is cool. We have a case study with Tampa general hospital where they came to us and in their first six months, they seen a two point 4,000,000 Roi. That case study is actually on our website, if you feel free to.
Dawn Willbarger (18:49) I did see it there. I was a little surprised because that was a pretty large savings. So it made me wonder what was happening within their organization that they weren’t able to get that done sooner?
Bijon Brydson (19:00) Yes, I actually don’t manage the account. So I’m not very hands on with it, but, you know, happy to connect you as we continue to go through the process of this, something, that is of importance for you. We have a ton of customers that are open, happy and ready to talk to organizations like yourself as you guys are, you know, figuring out what’s the next step. Secondly, are they one?
Dawn Willbarger (19:23) Of the situations that they outsourced it directly to you, is that the only model that you have?
Bijon Brydson (19:30) I wouldn’t say there’s a couple of different models. So, one is because we have services in place that’s just the way we go to market. So, I would say organizations have used us one of three ways. They have not a lot of staff today that is managing the process and, you know, they’re spread completely thin. They don’t want to continue to hire more people, but they want to leverage automation as a way of effectively going to market and scaling. Those organizations use us. Typically, they could be as they’re already growing or at the beginning stage. Then there’s organizations that pick a software only model, go through the software only model, continue to add people, you know, with their software, get to a point where they’re super heavy on the opex side and say, hey, we have way too many people that’s managing this function today. We want to scale that function down a bit and use automation, to focus our people focus our focus on being more strategic instead of focusing on a lot of the mundane tasks that are bogged down with credentialing today, right? Which a lot of that comes into the beginning of the process. And then once it’s sent off to those payers doing those payer follow ups et cetera. And we actually manage that on our side, then you have the third, which is, hey, we want to, we have a good subset of members on our team today, and we don’t want to grow anymore and we don’t want to get rid of anyone, right? So we want to take what we have and make it better. And those are the three stages in which organizations essentially come to us.
Dawn Willbarger (21:05) Today. Okay. Thank you. Yes.
Bijon Brydson (21:09) Ma’am, and then the third one which I think is the most important is removing provider abrasion. Obviously in today’s day where technology is very prevalent. No one wants to fill out 46 page onboarding packets or get, you know, a whole bunch of things that they have to fill out. We’re seeing a lot of organizations be able to keep and retain talent for one being able to increase the time for them to actually start billing and then more importantly removing a lot of the abrasion that comes with the onboarding process with the extensive paperwork like I mentioned, and just having a smooth way of getting all their documents uploaded and getting them passed through the process.
Dawn Willbarger (21:51) So, you just had mentioned, yeah, I think it’s like 100 page packet. It feels like when the doctors talk to me about it, yes, ma’am so how are you expediting that process? A?
Bijon Brydson (22:01) Lot of that is through our caqh integration. So we’re pulling a lot of the documents that are already there. And then we also have… we have the ability to use your smartphone to upload documents. So for a lot of think about when you go to a restaurant and you want to pull up a menu and you have a barcode, the same type of thing for us as well. A provider can literally take their phone, take a picture and upload it directly to their medallion profile, right? So it takes a lot of the friction out of getting your documents uploaded versus having to do the PDF and pull the PDF and save the PDF. Like it takes a lot of the friction out of the process.
Dawn Willbarger (22:43) Okay.
Bijon Brydson (22:44) Yes, ma’am so that is actually the last slide I have for you. I just wanted to give you a little rundown of medallion. I would love to schedule some time if you have the availability next week, if we can schedule another 30 minutes to where we can go through, get a little bit deeper in understanding the process, like what’s happening at each stage of the process and some of the negative consequences that are happening as you guys are continuing to go through. And then from there, I would love to, you know, get you seeing the platform so you could see the value behind why organizations are choosing us if that’s okay with you? Yeah.
Dawn Willbarger (23:18) Let me have a conversation first with our CEO and see if he wants to go in that direction. Again. I think he was thinking it was more AI that we could use with our current system to automate more functions within our current system, not so much outsourcing it to another organization to do some of that. So, let me find out from him what direction he wants to go in. And if this is something he’s interested in, then I’ll let you know.
Bijon Brydson (23:41) Okay. That sounds good. So I will send you a couple white papers after this call, just to arm you with some more information. And then if I don’t hear from you from Tuesday, I’ll just shoot you a quick note just to follow up.
Dawn Willbarger (23:53) I usually meet with him weekly. So if it can be by the end of next week?
Bijon Brydson (23:58) Yes, ma’am absolutely. I’ll reach out to you on Friday.
Dawn Willbarger (24:01) Okay. That sounds great.
Bijon Brydson (24:02) Alrighty. Well, you have a good one. Have a good weekend. Thank you. Bye bye. See ya.