Medallion Demo for Carilion

Transcript

Josh Hartle (00:00) I like polka dots today. Hello, everybody. Happy Friday.

Erica Lloyd (00:10) Hey, josh. How’s it going?

Josh Hartle (00:14) It’s going, it’s been busy weeks, but.

Mallory Smith (00:17) what are you telling me? What is this? It’s like end of quarter for us over here. And I’m like, did I work 17 hours yesterday or 18? I’m like, did I sleep?

Josh Hartle (00:26) I know. Yeah, we’re going through a we’re repapering a few pay your contracts right now and it’s yeah, a lot of busy work. A.

Mallory Smith (00:34) Lot of busy work. Oh, what were you? Just bored? And you were just like let’s renegotiate? I,

Josh Hartle (00:39) know, right, right. Well, I’m like even, well, some of them, it’s on our annual, but like there’s one we’re trying to even get delegated with right now. Yeah. And it’s you guys know, this probably kind of like in different ways but it’s like, it’s not a big payer but it’s again, it’s going to help us out in the long term, but a lot of busy work for the size of who they are. And I’m like, do I really want to do this? We do, we do, but it’s just like.

Erica Lloyd (01:04) Hey, Paul.

Josh Hartle (01:05) Our frustrations, oh.

Mallory Smith (01:07) Yeah. And you can’t tell them it’s just busy work because then you’re going to offend them?

Josh Hartle (01:11) Yeah, right.

Erica Lloyd (01:13) Happy Friday. Paul, hope it’s been a good week. Oh, I think you’re muted I.

Pholzak (01:18) know, and I always say, yeah, depends what program you’re in right? Though?

Mallory Smith (01:22) Pretty much. Yeah, then.

Pholzak (01:24) There’s the one that like light you up like the video and the sound you’re like, no?

Erica Lloyd (01:32) Josh, do you, I know you have, yours are what you said? One three and five, do you have boys or girls?

Josh Hartle (01:40) Two boys, one girl?

Erica Lloyd (01:42) Is the girl, the five year old, no?

Josh Hartle (01:45) She’s a three year old. She’s right in the middle? Yeah.

Mallory Smith (01:47) That was my family. I was the one. Okay. Yeah, they came out on me too. My God, they said I got preferential treatment and everything.

Josh Hartle (01:55) Yeah, she kind of gets what she wants all the time boxes her brothers around.

Mallory Smith (02:00) Just biology really at the end of the day.

Erica Lloyd (02:04) There you go. My five year old daughter is wild. So I was going to ask if yours is also.

Mallory Smith (02:11) Yeah, any tips and tricks send us, Erica’s way, but really, she says she’s like my daughter too. Now. I don’t really know when this adoption happened, but yeah, if you send them our way, be great.

Josh Hartle (02:20) There you go. We’ll do we’ll do?

Pholzak (02:22) What’s the oldest?

Mallory Smith (02:26) So,

Erica Lloyd (02:26) I have a nine year old son. He’s so much more chill than my daughter.

Pholzak (02:30) How old’s your daughter?

Erica Lloyd (02:31) She’s five.

Pholzak (02:35) All right. I.

Josh Hartle (02:36) Will say my.

Pholzak (02:38) daughter, I love her sister man. I know what I could get away with and what I couldn’t get away with.

Josh Hartle (02:42) Yeah, my daughter, she makes up for. She’s so loud she’s so loud compared to her brothers. It’s just like I’m like, hey, use your inside voice. I’m right next to you. I’m right next to you, but she’s full of energy. Oh, yeah, I love her.

Erica Lloyd (03:00) Absolutely. They’re crazy. All right. Well, thank you so much for carving out some time here. So, I think the goal is really, we’ll give you a visual of what we’ve been discussing and really like want to make it pretty easy to map it back to your business value. Sure. And let’s also just hold some time at the end. We’ll think about how we start looping in some executive sponsorship if you want to champion this.

Josh Hartle (03:27) Yeah.

Erica Lloyd (03:28) And then I can kind of walk through some of the next steps there. So I was thinking for agenda. I’ll just do a quick recap like what we heard, make sure we’re mapping to the same things. I started putting some numbers. I put some additional numbers together based on what we talked about yesterday. I imagine as we’re socializing this up, probably going to need some hard numbers to say here’s where we’re going to find spend, how we’re going to reallocate, and you can kind of go through where people usually reallocate. And then Mallory put together where we’ll spend most of our time is Mallory put together an incredible demo. So we’ll go through the demo and then we’ll I want it to be interactive. So please, you know, jump in with comments and questions. Oh, and actually before the demo, thank you, josh. So much for sending the payers that you are non delegated with. So let’s just we’ll just go through the turnaround time. So I think there’s a pretty nice delta that we can get… from our turnaround times to your turnaround times. Anything else that either of you are hoping to get from the call today?

Pholzak (04:38) No, that sounds good. Probably as we go through it, I’m sure it’ll come up.

Erica Lloyd (04:42) Okay.

Erica Lloyd (04:42) Sounds good. Am I sharing the right screen? Yes. Okay. So we won’t spend a ton of time here, but I just want to make sure so the manual process was Symplr. It’s leading to we had 58 missed start dates by around 30 days. Is that accurate Paul?

Pholzak (05:05) I would just put 58 missed start dates. Okay. I mean the reality of it is we just want to not have a missed start date. I mean, even by one day, it doesn’t really matter. You missed it. I.

Erica Lloyd (05:17) Think where I’m going with that is when we quantify this. So thinking about what the value like the Roi multiplier would look like to make the investment. Typically, we see like a three to five X multiplier in Roi, and if we can recoup that, that’s where a lot of times the funding will come from. Sure. So sorry, what was that? Paul? No?

Pholzak (05:37) I understand why you said that. I don’t know how you’re going to like equate that into revenue, but… I can just tell you the sentiment in the organization is we don’t want to miss start dates. I don’t even think and we’ve never had a conversation about revenue. We’ve had a conversation about just the fact we missed the start date and how that’s just not good for retention. How it’s really a bad impression on the candidate and why there’s like a number of reasons it’s no good and all the downstream impact which is epic training and orientation and, you know, onboarding and, you know, I can just go through the list. I mean, I appreciate you saying that in terms of what the revenue impact is. But just to let you know, I mean that’s the driver here, it’s bad for business. Okay? You know, what? The challenge we’re having on the credentialing side is the fact that and I can, I mean, I can tell you this, I mean the missed start dates are not a product of the credentialing process. It is a product of our internal process which is our leaders are told 120 days you submit the contract, the pif, right? The pif, which is the position management form and your candidate will start on the start date. Well, that’s completely baloney because it doesn’t work that way.

Pholzak (07:15) It’s because that 120 days is just a math equation. It doesn’t line up with the credentialing process, meeting schedule. It doesn’t line up with the pay period Monday that happens, you know, the argument’s sake twice a month, three times a month, depending on what month we’re in. It doesn’t line up with the fact that if the candidate doesn’t sign their contract on time… then the start date gets missed. So I can tell you with confidence, the root cause here isn’t the credentialing team. The root cause is the things I just explained to you that there’s a math error to begin with and they don’t and it just doesn’t and we have, no, we don’t do a good job of controlling the candidate. And that’s why I brought that up in our last meeting that’s where the credentialing team gets beat up is that they don’t have, they don’t have the time or haven’t developed enough the right skill sets to actually go out and say to the candidate, right? While you’re working on your contract. We already did this since I’ve been here? We went ahead and said, I don’t care about the contract, send them the credentialing packet, get them to fill it out. And they did… and they’re not, then they didn’t, they missed their first credentialing go around last month because they didn’t sign their contract, their employment contract.

Pholzak (08:45) Yeah, you can’t do the final step of credentialing because they didn’t sign their contract. So, the point is on this though is that the missed start dates are a function of both of the entire organization working together. What is important to us here is that the process that we’re currently using is a paper process, And it’s time consuming and our team, the hybrid model would work because the team, then we can skinny them down and say, look, we don’t have to be bothered with this paperwork. This is a, we have ways to have KPIs. And what I want to do is shift their focus to say, you’re going to manage the candidate. You’re not going to push paper. Yeah, this is what we’re talking about here. This is why I’m so excited. We’re not pushing paper. We’re not tracking things on KPIs. We’re not tracking the data. We’re not tracking anything as a team. You are, what I want to do is say, okay, this thing has been kicked off. These are the milestones we need to hit. How are you managing the candidate? Not the credentialing process, right? Because that’s what we’re doing. We have somebody who sits down and says, I have all this paperwork to fill out. I got this form to send, you know, I got to wait for them to send this back, right? And all of a sudden, I’m telling you we send it out and then we’re like, how do they get it back to us?

Erica Lloyd (10:10) Yeah, I mean drop.

Pholzak (10:12) It off, I’m like, do we not have courier services here in roanoke where we could go get it? Yeah, I’m like do you realize like 30 bucks to get a courier service to get something from somebody’s office to bring it over here in three hours is going to save like two days worth of work because you’re waiting for them to drop it off or they can’t print something out in their office or at home. So, this is where we’re at the part about this conversation that’s so attractive to me is that you have an electronic process. You have a process where you’re going to manage all of the paperwork. You’re going to manage the flow with the candidate in terms of candidate, you have it, just fill it out and get it back. We can cross reference whatever we need, right? We can be very efficient here and it’ll help then the hybrid model here, which is we do have boots on the ground here. And then that’s what my expectation, is they’re going to manage the candidate?

Erica Lloyd (11:12) Yeah, no, I mean, yeah, you’re completely right there. And I think medallion is really transformational because there’s a lot of different areas that is impacting. So, typically, we will see a CHRO, a coo, and a CFO across.

Pholzak (11:31) This.

Erica Lloyd (11:31) And sometimes even legal because it touches so many aspects. And so, when… we talk, when we socialize this, and usually we need kind of yeses across the board to move forward with it. And when we’re talking to a coo, they’re thinking about EBITDA and opex savings and things like that. And chros are thinking of exactly what you’re thinking about Paul and, you know, candidate experience and things. And then, you know, Don and like a CFO or something is thinking like, okay, how do we improve our margins so we can expand access? So you’re.

Pholzak (12:06) completely, right? Because you are going to fail if you say you can make those go away because you can’t because the fundamental problem we have here is the contracting side of it. You can do this 100 percent all day long, but if the physician or the physician does not return their signed contract to us, they will not go through the credentialing process. They will miss their start date and.

Mallory Smith (12:37) I think one thing you said last week that stuck with me was you’re given 120 days to credential a provider. It’s not ever going to take that long, right? So, this isn’t necessarily a speed play or an efficiency. While those are features that you’ll see today, it’s more of the electronic process like you said, just making it easier for providers in general.

Pholzak (12:58) We’ve already committed in 90 days.

Erica Lloyd (13:05) That actually is a good tee up. Mallory. Again, Nick said, josh, thanks for sending those turnaround times. Why don’t, we do that? Why don’t, we just do the analysis of the turnaround time. I think that’ll be a good way to segue into the demo.

Pholzak (13:18) I’ll tell you music to the ears of the people you’re going to talk to. It’s, an electronic process, go back to the whole buy in the house thing as we are doing right now. My wife and I, that is the biggest criticism. I mean, I’ve been out there. I mean, I’ve been physically talking to people about this and all they’ve said is like it’s 2026. Why do we have a paper process? You guys coming to the table with a fully electronic process and being able to support us and being able to show your efficiencies and being able to provide benchmarks and metrics, is music to those C suite people you talked about that’s music to the ears?

Josh Hartle (13:55) Yeah, because I’d say even a challenge and I don’t know if we’ve talked about this in the past too, but not to minimize it with what Paul said is the KPIs too? Symplr gives us no analytics or dashboards right now. For me, the executive leadership wants like, how are we doing with getting providers to network what’s our revenue at risk? What’s our lag in cash flow too, and we’ve had to create manual data points to track that information, pull the information from symplr. Puts it in tableau dashboards that then we have to audit to make sure there’s no issues and we shouldn’t have to go through all those hoops to get that like I should be able to print off a report, send it to my VP and CFO and then they can, okay, cool. We’re on track or we’ve improved by X. I think that’s a thing that you all can help us with quite substantially.

Erica Lloyd (14:44) We’re excited to show that one. Everyone loves data.

Josh Hartle (14:48) Oh, yeah. And good data. Good data. What?

Pholzak (14:52) I’m excited about is the fact that is what I’m doing in some other places is to be able to say this process that we’re working with on medallion is airtight. And I got data to prove it, guess what here’s where we need to spend time working on it legal department. Do you realize it’s taking you 46 days to get a contract signed, why, right? And then all of a sudden they’re like it’s credentialing. And that’s the part that team that wants me that’s the part that rubs me the wrong way because that’s where they go. It’s credentialing’s problem. And I know, right? Nobody likes to know it all. I’ve only been here three and a half months, but the point, is I’ve only joss has been in the same boat. We’ve had conversations and we realize we already see the problem.

Mallory Smith (15:43) So Paul, you mentioned like he’s mentioned like 46 days as a data point, how do you know? It’s been legal for 46 days? Where do you track that currently?

Pholzak (15:53) Well, what we’re doing is doing it manually on a spreadsheet because I don’t have an ATS and I don’t have it’s the same thing josh is dealing with. We have, we have programs that’ll give us the data, you know. And for right now though, what I’m working on is simply just trying to get baseline information, I know from a national standpoint where we should be.

Mallory Smith (16:19) Absolutely. Now, I think it’s interesting because you could track that information in medallion even before you send out the invitation to the provider that’s the standard metric point that you can track as far as like when they sign agreements, you can create tasks. There’s there’s just ways to track.

Mallory Smith (16:34) So, I was just curious, but it sounds pretty manual right now. I’ll go ahead and share my screen. Josh. Thanks again for sending this over. Yeah. Just a minute. I’m sorry, zoom updated. What does the new share button look like? Oh, I found it. We’re good.

Josh Hartle (16:49) All right.

Mallory Smith (16:54) Don’t, you love that like somebody somewhere decided this would be a better way to go. And we’re all like, right? We’re all just like come on, man can’t you just leave the.

Josh Hartle (17:00) button on?

Mallory Smith (17:03) They moved it all the way to the left this time, perfect. Okay. Are you able to see my screen?

Mallory Smith (17:08) Yep. Yes. Okay. Thank you. So let’s go ahead and talk about just the pay or turnaround time analysis. So, josh sent over the plans that you’re currently non delegated with as part of the visual workflow today. I do plan on covering the credentialing process and delegation management, how we could just help your team from that perspective. But ultimately, if we start with non delegated with the list that you sent over, there are a couple of questions that I did have, but this is our average turnaround time that we see specific to your state? My first question? Ameritas, dental. We actually had medical turnaround and then dental turnaround too. So is this your medical providers like dental surgery or what kind of providers just?

Josh Hartle (17:48) Dental.

Mallory Smith (17:49) just dental. Okay. Then I’ll get back to you on that. Okay. So DDS?

Josh Hartle (17:56) Correct. Yeah.

Mallory Smith (17:58) All right. Thank you. And then I’ll I can just briefly run through. Ultimately, the result you’re finding is that there were a few that were pretty lengthy dentaquest, don’t know what they’re doing paper process probably, but ultimately.

Josh Hartle (18:11) They are, they are, yeah. Okay. Like all dental is paper to be honest. Yeah.

Mallory Smith (18:15) Yes, yes, no, you’re not wrong. We do work with a handful of dental clients here at medallion and that’s been the overarching theme with them. Especially with enrollment. They’re seeing quicker turnaround times with medallion, but it’s still just such a pain. So, all of these put together, you’re going to have an average, about 50 51 days for the turnaround time for your non delegated. I do have a question though and I wasn’t sure if you’re pranking me or not. Is this a real payer? Like I could not, what is Nhi?

Josh Hartle (18:46) I need to figure out what that’s for.

Mallory Smith (18:48) Okay, good. Because I’ve never heard of it before and I was like, is this testing us to see.

Josh Hartle (18:54) are you pranking me? We said.

Mallory Smith (18:59) That we Mallory. We joked, we said maybe they’re trying to see if we just throw a number in. Yeah, exactly. And I was just like, I was like, I’ve searched the sigma database. I’m like this is, I don’t know what this is, but if you get back to me and you’re just like it’s just like NC medicaid or maybe it’s like an mco, then?

Josh Hartle (19:15) Let me know. Yeah, I want to say that might be NC medicaid. Okay? For some reason our team just named it that way, but I’ll double check.

Mallory Smith (19:22) For you.

Josh Hartle (19:22) No.

Mallory Smith (19:23) Okay. I’m going to put that note in here. Good to know that you still trust me though.

Josh Hartle (19:28) Yes, yes. All right.

Mallory Smith (19:30) Okay, perfect. So, just as you kind of review those results for the others that we were able to find for you, do you think that’s par with what you’re currently experiencing? Do you think it’s better?

Josh Hartle (19:43) I’d say the one thing that kind of stopped me was Virginia medicaid. We typically get that in three to five days. Okay? With state medicaid, everything else looks about the same is.

Mallory Smith (19:53) Virginia medicaid, is that a portal?

Josh Hartle (19:56) Yeah. So that’s the, that’s like the state medicaid. And then we then have to do enrollment with all the mcos that medicaid contracts out to. So it, even though we do Virginia medicaid, they’re just still like anthem medicaid, you know, healthcare medicaid, we then have to start, but we can’t do that until we have Virginia medicaid done. So, it’s really a checkbox. It’s not like a woohoo. We’re through the door. It’s like part one. Now, we can go to part two before we can start billing. Okay?

Mallory Smith (20:21) Perfect. Thanks. What I can go back and check is the date parameters as well. So, for the three to five day turnaround time, have you been experiencing that for a while? Like past six months, 12 months. Do you have a defined range?

Josh Hartle (20:33) Yeah, I wouldn’t say past two years we’ve had that it might, I think our average once has gone up to like nine days, but it’s they’ve made some tech improvements with Virginia medicaid that’s helped. Okay, perfect.

Mallory Smith (20:45) Thanks. I’ll take that back to the team and I’ll see if we can figure out with the portal because of course, we do have portal automation where we have different portals set up to auto populate submit portal scrapers that check every single night. So I will check specifically for Virginia and see if I can get that back to you.

Josh Hartle (20:59) Yeah, I’d say the West Virginia medicaid that’s a lot shorter. I think right now we’re currently around 90 days. Okay? It’s a portal as well. Aetna. I want to say we’re close to 60 70 days and that’s been more so they’re hitting a lot of delays with loading our rosters. Now, Aetna is a delegated payer though, I would say, okay.

Mallory Smith (21:24) So the Aetna mco, that was specific. And once you get the provider’s medicaid number, then you submit for that plan?

Josh Hartle (21:29) Correct. Yeah. Okay. All right. Yeah. So that would be, that would not be a non delegated. Okay?

Mallory Smith (21:38) All right. So again, thanks for providing that information. Just wanted to get you those numbers. I can send it to you as a takeaway, and then I can look into that Virginia medicaid perfect. I am curious just because we keep talking about courier service. Do you have any applications currently that you have to print out and have the provider sign wedding signature?

Josh Hartle (22:02) I think we’ve this year. We for payer enrollment. I think we finally got rid of that. Okay?

Mallory Smith (22:08) Good. I know that some payers were particular about it, but Paul was mentioning earlier about just like the courier service and what we’ll do is we’ll actually print the applications out in triplicate and then mail it to the provider’s home in a ready to mail envelope and they just sign and they just put it back in the mail. So, very loud and clear, Paul. But good thing is that you don’t have to deal with that right now. It’s specific to enrollment. Yeah. All right. Erica, is there anything additional you wanted to cover before we get to the demo today?

Erica Lloyd (22:37) No, no, yeah. Let’s get into it. And like I said, just to tee us up, we’re going to start with the analytics and reporting modules and then we plan to go to the provider onboarding. So, Paul, that’ll be an exciting one for you, and then we’ll talk about payer enrollment… and then if we have time, we could do the credentialing and delegation? Okay?

Mallory Smith (23:03) Anything else in that roadmap that you would like to add to coverage today?

Pholzak (23:13) Does that have anything to do with the slide? We’re looking at? What was that? What we just, the three points we just went over? Does that have anything to do with the slide we’re looking at?

Mallory Smith (23:23) So this is not a slide. This is the platform itself. I think, right. Erica, is it the platform? Yeah, this is the,

Erica Lloyd (23:30) yeah, this is the analytics tab, so we’re actually in that, so.

Mallory Smith (23:34) This is the live environment at the platform. Yeah.

Erica Lloyd (23:38) She customized, with your logo to make it look.

Mallory Smith (23:42) More real. I got you now, yes, understand. Sorry, yeah. So we do have customization options. So I wanted to give you a real look and feel. So just a couple of things of note, you’ll see your logo at the top left of the platform when you log in and then over to the right, you’ll see that for this tenant, you are carilion clinic. So we have the option of making it multi tenant. I don’t think that would be necessary for your use case. But when we get to the scoping aspect, we can absolutely kind of dive in there more. But no, this is the live environment. This is going to be the analytics tab. And just to get us started, we have one for every segment, whether it’s licensing, credentialing, we even have a provider onboarding one that I think is pretty nifty. And Paul, that’s going to give you data points such as when the provider was invited to the platform, how long it took to track or actually have the provider log in, how long it took the provider to complete the onboarding profile. And again, right now, from across the organization, we’re seeing like a two day average onboarding because we’re able to partner with caqh. I’m going to show you that as a visual as well, it does gather about 75 percent of the provider’s data, which is why it’s a quicker turnaround time. But ultimately, when we think of analytics, this is perfect for your scalability forecasting and growth. This is going to give you real time data updates on where providers are currently at, in the intake process, versus when we’re waiting to hear back from the payers, what’s been requested, recently, what completed enrollments have come through status transition time. So every single data point I like to say in the system can be tracked. So even if you needed further analytics in this, we do have a custom analytics team on staff here that you just give the data points with the larger organizations that we work with. They probably have pages. I could just sit here and just scroll for the analytics that they need. I’d be happy to send you screenshots and de, identify the information just to give you a general idea. But ultimately you’re going to get the visual aspect. When you think of analytics, anyone in your organization can have access to this. You also have the ability of exporting these. So if you wanted to attach them to a leadership presentation, if you want to send to anyone in that regard, you do have the option of opening them, opening the metadata. And then in just a minute, I’ll show you the reporting feature on how you can create your own reports in addition to the canned reports. But I’ll pause here for just a minute. How does this look and feel compared to current process? I know you mentioned you’re kind of lacking on the visual department right now.

Pholzak (26:12) Yeah.

Josh Hartle (26:14) I think it’s great. I guess my question would be it sounds like we can get more customizable with this if we need to. Because sometimes like with Paul’s team and my team, we can sometimes have processes or workflows that are parallel. So it’s not necessarily like a start. And then a, this is ending now start this that happens sometimes, but sometimes it’s we’re doing things at the same time in tandem. Yeah. So that sounds like that would still be able to happen and track those two workflows even though they’re going on at the same time.

Mallory Smith (26:45) It absolutely can. I think that’s a great call out. Josh. We also have team management and team viewer. So if Paul, if everyone on your team needed to see specific information to recruiting efforts to onboarding intake efforts, and then josh, if you wanted to focus on delegation, non delegation, then anyone that’s a member of your team, you can have their view restricted that way. So of course, comprehensive role based access control with that in mind.

Josh Hartle (27:09) I think a big thing for me that I like when I see this too is like task summary. There’s not like symplr has tasks right now, but we have to manually create them. It’s not like something like, all right, I’m going to send josh a task because dr John’s license is about to expire or it’s been 32 days since we’ve heard back from a payer when we should have heard back at 30 days. Therefore, I’m going to have a specialist follow up with that payer application… and then correct me if I’m not wrong. So, as our current state today, we send our providers a ccbs, sends them like a 40 page packet that basically has like work history disclosure questions. We’ve been also sending a PE packet that’s like 10 pages but has disclosure questions. An area that you guys streamline that for, is that one integration with caqh kind of answers all that packet already, whether it’s work history malpractice, that way we’re not having to have the provider kind of re, provide that information. Is that correct? That’s kind of where we’re getting our efficiencies from? Just want to make sure that’s everything okay? Yes.

Mallory Smith (28:14) I think it’s a great call out. Okay?

Pholzak (28:17) Go ahead. I was just going to say that’s you know, that’s the kind of stuff that, you know, we would be really interested in knowing, right? Is knowing the value, right? The fact that we’re not asking them to fill out the, you know, the same form if you will, or the same information twice? You know, what can you do for the provider ahead of time? You pre populate something? Do you make it more user friendly? You know, how, you know, how is this right? You already know we have a paper and pencil system, right? So, you know, what’s the difference between that and what you do, you know, highlighting getting ahead?

Josh Hartle (29:00) Of us?

Pholzak (29:02) You know what I mean? Yes.

Mallory Smith (29:04) Absolutely. Because.

Pholzak (29:07) Some of this stuff too, right? It’s you know, that we would talk about, you know, kind of it might be a little too much in the weeds. You know what I mean? It’s more about like, you know, what does it mean to the candidate, right? What does it mean to the candidate for us to have this in play? And how do we seem one we’re in the 20 first century and two that they’ll say, wow, this was kind of a painless kind of an easy way to go about it. And I’m on, you know, I’ve got my credentialing stuff filled out and I’ve got my PE stuff filled out and I’m not doing double work. And you know what I mean? Because that’s really what we’re looking at.

Josh Hartle (29:48) You bring up a question or a thought Paul that I think would be great for us to ask. So at carilion, our physicians and clinicians have to get re credentialed every three years. Typically, how does that work in this whole process? Basically helping us again automate that process to really it’s like behind the scenes, it’s not even a very big lift for the provider. It’s really just something we have to do internally to meet a regulatory requirement. How would we track that in here with analytics?

Mallory Smith (30:22) It’s automatic. So I can actually if I were to go to the credential tab really quick scheduled re creds. So if we credential them on a certain date, it’s going to automatically add them to the queue three years from now or it’s configurable per client, but yours would be every three years. And then it also automatically starts that process. So no one from your team even has to log in and initiate it or have to follow up with it. It’s just something that’s running in the background. And when we go to the credentialing back to the analytics credentialing analytics. Okay, you’ll be able to see re creds initials, how many have been open so far? How many are sitting with the committee? Just various points like that?

Josh Hartle (31:03) So, kind of the pause point like what’s the current candidate… experience? Like they’ve been with us three years already. This timeline’s now approaching because like right now they get the whole 40 page packet again of like, hey, what’s changed in the three years? Like what’s the lift for them? Or is this because we’re always maintaining stuff that’s really, they’re really not even notified of it. It’s really more maybe ccds letting the committee know like they were re credentialing this like what does that look like for the candidate’s perspective? Not from like me and Paul’s perspective per SE?

Pholzak (31:37) Good question, right? Because that’s a great question because again… it’s not like we can’t do it. It’s not like we’re not doing it, right, right? And that’s it’s about the candidate experience because if we wanted to go down the road and talk about re, credentialing, right? And when we kind of like, you know, kind of diss the current process, it’s not going to go over well because it’s not like we can’t do it because remember, I initially said, the issue here is credentialing and the signed contract coming together. Well, that’s the contract piece is out of the equation because they’re already kind of right? So it’s not like they’re missing this, right? But it’s about the candidate experience saying three years, I got to fill out this stuff. You know, how do you go? How do you compare to a paper pencil system, right? Why is it so amazing to be like, ha, this is cool. This is all stuff that’s automated. This is all stuff that’s going on do, just go down that candidate experience route, right? On the flip side just so, you know, we don’t have, if you’re credentialed at our main hospital here as an example, which most of our physicians are, and three months, nine months down the road a year down the road, they want to go to one of our outlying hospitals. They have to get credentialed all over again. And they have to go through the entire process. That is we’ve got a lot of physicians. I don’t know the exact number. It’s a lot that actually go through that process at some point in time. So that’s another piece of it which is not only did they just do this, but literally nine months down the road, they’re going to have to do it again because they’re going to want to go to another one of our hospitals which is they have their own medical staff. They have their own bylaws and they have to go through the credentialing process again.

Mallory Smith (33:37) Absolutely. It sounds like you’re describing hospital applications. So you mentioned medstaff bylaws, I think joint commission level credentialing is that what your providers to have admitting arrangements there? Yeah. Okay. We are full service. We can help with hospital applications. I’ll take, I’ll answer both of you in a couple different parts to get to steady state. We will have a data migration process as part of the implementation. We do not bother current providers until we are ready to go live. And then I’m going to show you an example of the welcome email. In just a minute. They’ll basically log into the platform and see a completed profile because we’re bringing all your current information from your vendor over to the medallion platform. We’re doing data quality checks. We have apis up against the npi registry to confirm npi’s primary addresses, taxonomies, all those different specifics. And then from there, they’ll log in, they’ll review it. They’ll basically attest and say, yes, this stuff is accurate. It is a current provider that they don’t need anything for the next year or two. Maybe they don’t have any regrets with payers needed. They don’t have to log in for the next year or two. But whenever we need action on these providers, then that’s when they’ll get the ping from an email to basically say, hey, please just log in and review the great thing. We’re talking about experience today, mobile friendly view. And I’ll give you an example of what that looks like too. They can do all of this from their cell phone. So electronic signature connecting to caqh, you name it. Okay. Great. So it sounds like we want to kind of get into josh. You did mention tasks. So I wanted to show that to you briefly. So when we think of tasks, there’s going to be a specific payers a specific payer task or you can find them here under the payers module itself. But for all the other tasks, whether it’s collecting information, renewing, the boards, keeping up with their driver’s license. Just examples like that, you’ll see all that reflected here. They are automatic to your system point. We do have 30 60 90 day reminders. They are configurable. So if you wanted to send weekly reminders, if a provider does not want to receive emails, we can turn that off as well. So it is customizable to the provider experience. If they would rather have their admin handle it and notify them directly if they need something.

Josh Hartle (35:53) I would say with that too because when I used medallion, this was very helpful. You all can send a weekly email, say, for like, josh, you have these tasks that are outstanding for you or your team because right now.

Pholzak (36:04) We.

Josh Hartle (36:04) don’t have that. It’s tasks. I’ve manually created to do that. So, if.

Mallory Smith (36:10) we go into an individual provider profile and I go over here to email preferences, weekly provider reports. I can toggle that on or I can toggle it off. This is specific to every single provider, so they can be as involved as they’d like to be cool. Yeah. Okay. So just want to give you a brief glimpse there. I know it’s more of like the features, but just to kind of round it out, we do, of course, consider that. So whether it’s task expirables for any document that has a date on it, if it is communication preferences to the provider, and then where we can go next is to just the provider onboarding experience unless there’s anything you’d like to see first.

Pholzak (36:48) Okay. Yeah. Just a random question. So if you said, hey, we need an updated copy of your driver’s license. Can I take a picture of it with my phone and just upload it?

Mallory Smith (36:58) Honestly, you’re taking my thunder away right now. Oh.

Pholzak (37:01) Sorry about that.

Mallory Smith (37:04) Let me do my song and dance the.

Josh Hartle (37:06) answer.

Mallory Smith (37:08) Is, yes. But that’s my favorite feature to show because we get so much feedback from customers and providers. We have a voice of the customer every quarter that will speak to us at medallion. And the picture feature is like one of the ones that the providers are just like, I love it because I mean, you think about it, their diploma is up on the wall. They don’t want to take it down. They don’t want to untack everything. They just take a picture with their phone and AI OCR technology basically scans it saves it as a PDF, even helps name the document. So, of course, we have it, we have everything we’re pretty new service. Okay? We can.

Pholzak (37:43) Just loop through that being like look, we’re super cool and easy and transparent to work with. So, do you just want to sign?

Mallory Smith (37:50) I mean, I would love to say that sometimes where I’m just like you’re gonna love us, I know that already. But essentially, when it comes to inviting providers, you have a large provider volume, I would recommend just bulk invite. It would be uploading a spreadsheet to the system here with their name caq hid npi and email. And then that’s all we need. It’s gonna connect to their caqh automatically, bring over the profile data and the documents, send out a welcome email to the provider. They can log in, review things like that. When that invitation is sent, the provider’s gonna receive an email that looks something similar to this. So you’ll have your logo up at the top. You do get the option of controlling the email body. So if you want it to be more specific to carilion or anything of that nature. Once the provider receives this email, they’ll then go through what we call just like the onboarding process. So they’ll receive an email, looks similar to this. Carilion clinic has partnered with us. They’ll get started, kickstart the profile, multiple data ingestion methods here. So of course, see a QH, if the provider links it, see a qhid, social last name. If you link it for the provider, see a qhid, npi last name that’s all we really need. And then we also have a resume. Yes. It is especially when you’re not having to track them down for the username and password. I have a sister in law who’s an OB gyn every year in April like clockwork like I’m waiting for it any day. Now. She’s gonna call me and be like, do you remember my caqh password? I have to retest and I have to help her reset it. So it’s just been doing that for 10 years now and it’s fine. But ultimately other options resume scanner. So, OCR technology upload a copy of the resume and then API integration. So obviously with the size of your organization apis to HRIS platforms downstream to your scheduling systems, to your reporting to your billing, any of those features are available as well?

Erica Lloyd (39:51) Who?

Pholzak (39:52) Follows up on this? Who follows up when we have 160 of them, say, yeah, I signed up and we’ve got 40 who have ignored these emails.

Mallory Smith (40:04) Automatic notifications go to your admins. So I would probably designate someone. We will send automatic notifications to the providers. We also have conversational AI. So they will call and text the providers if they call a provider and say, hey, this is so and so call on behalf of carilion clinic, please log in to medallion. Please provide a copy of your Coi face sheet. The provider can even interact and say what’s a Coi and it’ll say it’s your certificate of insurance. If you want a secondary demo, I can have that prepared for that demo just so you can actually have a conversation with it just to see how intelligent it is. So, there are multiple ways that we follow up directly. And then you’ll be getting an active report every day on how long has this provider been sitting here. And then you’ll also see just the cumulative average of how long it takes providers to complete the goal. Of course, when you have your qbrs with our team would be that you see that number decreasing every single time?

Pholzak (40:59) I’m going to tell you that’s super important. We are getting… weekly nudges… and it’s been clear from our system CEO about how are we integrating AI into the work that we do?

Mallory Smith (41:19) Okay, awesome. And yeah, I can definitely speak to that.

Erica Lloyd (41:23) We’d say more Paul, I want to hear it.

Pholzak (41:25) It’s huge. Oh, it’s an expectation that every single department, every single leader in the organization on the administrative side has a game plan in terms of how to move toward or integrate some aspect of AI into their workflows. It has been delivered clearly that this is the only way we’re going to be competitive is if we stay in the AI stream?

Erica Lloyd (41:54) Yeah, double clicking there because that’s we’re talking to a couple to more than one Virginia health system, carilion size that has some are a little bit further down this, down the path of AI automation. This is like the last kind of phase is like, okay, we’ve now done it in our doc, you know, we’ve been integrated ambient. Scribed. We’ve been integrated AI on the front end in our facilities. And now it’s time to take it to credentialing the credentialing side. And that’s like where it’s picking up steam.

Mallory Smith (42:27) Is it, has there?

Erica Lloyd (42:28) Been anything already integrated? And now it’s like, okay, now, how are we doing it with credentialing or is it like, is this project called? Anything? No?

Pholzak (42:39) There hasn’t you know, there hasn’t been anything that said anything in specifically, but it has been clearly delivered that we need to continue to look, and adopt as soon as possible. I can tell you that, we had a signed contract and workday implementation came on board. But we are moving forward with phenom and if you’re familiar with phenom, it is a, it sits on top of workday and it is a extremely powerful AI platform for candidate recruitment across all of Ta. And this includes physicians and apps. And it has been, they’ve been around at least 10 years and we have relationships with and with organizations that have done this. So this is a big deal. This is a huge move on our part. I’m excited about it and to be able to talk about the fact that we have AI capability in this is huge because I know that phenom is not going to get rid of our recruiters. It is going to do exactly what your AI does, which is it helps them manage the mundane to the point where the mundane is still just, you know, Mia from the candidate side again or in this or our employee side. And then that’s where the human part just needs to kick in and manage like who’s just not engaging? And that’s so it’s huge. I mean, if you talk about anything man, I would say that up front as soon as possible. Yeah. How that is going to complement the hybrid, the staff that’s here because nobody’s nobody is actually at a point right now where they believe like we can go like we don’t need anybody physically, you know, in a human form to be part of the process, right there’s. That has not happened. I mean that’s not happening anywhere but what it’s doing though is doing exactly what we talked about here, which is, yeah, but it’s going to go ahead and shake the bushes until the point where we have a reporting process obviously that will tell us that we still got a candidate or a current physician who is just not reacting to what we’re asking for. And then that’s where it’s our responsibility to figure out what’s our plan… exactly. Yeah.

Mallory Smith (45:26) I think we can work with that. And I even have slides that talk about the AI and automation and how it’s segmented with each aspect, which of course.

Pholzak (45:34) Will provide.

Mallory Smith (45:35) More charge.

Erica Lloyd (45:38) You know exactly what you were saying? Paul, like it’s not going anywhere like the AI initiative. It’s like we, if we’re we have to, it’s a matter of how and when not or it’s a matter of like when and who you’re going to, which vendor you’re going to choose to do it because at some point like there’s going to need to be AI and everything. And I mean, it’s just like we need technology to lower the cost of delivering care bottom line, like where and how are we going to do it? Yes.

Mallory Smith (46:10) Perfect. I appreciate the call out Paul. So we’ll keep going with the onboarding flow and I’ll be sure if I remember to talk about the AI components of it, but I’ll definitely follow up with those slides just to kind of show you. And again, if you present internally, it would definitely help you.

Josh Hartle (46:28) Yeah. And to Paul’s question with this, sorry to keep stopping. But from my experience in medallion, isn’t there like a donut somewhere in your provider list that shows, but also is kind of like a mechanism for you to track who has not started the process as well. Yes. Yeah. Okay.

Mallory Smith (46:47) Yes, because there’s two specific data points. So the first one is who has been invited to the system. And then the next one, I guess there’s three who has been invited to the system, who has not yet accessed the system. And then, so if they haven’t accessed the system, they haven’t gone through the onboarding process, they haven’t clicked the email basically. And then once it’s complete, so you’ll have each of those specifics so you can see exactly where the bottleneck is occurring. And then I’ve had clinics come back and basically threaten like monetary funds from the provider and be like if you haven’t onboarded by this day, you owe us X number of dollars. So that’s up to you about how aggressive you get, but I’ve definitely seen it, right?

Pholzak (47:25) Yeah, yeah.

Pholzak (47:33) What’s helpful is that you guys, is that, what this does though is it says this person has not done anything yet, right? And then, and we, and then I’ll that’s a lead indicator, right? Like if this person hasn’t done anything yet as of this date, we know, we, it’s like, okay, we got a problem child here, right? Or we got somebody who just doesn’t you know, it’s just or we’ve got the wrong contact. You know what I mean? Like, you know, it’s not all about them, but the point is this is where we want to be, right? We want to be like, hey, instead of, okay, let’s be blatant here. Like, I’m sure you guys hear this a lot. Well, they’re just not getting back to me… right? Well, if you have the metrics that say, hey, guess what? They’re not engaged, like it’s not them. It’s like, what are we doing about it? You know what I mean? Yes, they’re not engaged. Okay? It’s also, yeah, they may.

Erica Lloyd (48:29) Not, I mean, that could be a leading indicator there, but they may not start, you know, they may, if they’re disengaged, yeah, you have a risk on your hand. Yeah, you didn’t get it back bill.

Pholzak (48:40) Right. That’s where we want to be perfect.

Mallory Smith (48:44) Oh, man. You took me down memory Lane there, Paul. Okay. So I’ll wrap up the provider onboarding experience. I’ll wrap it up by showing the mobile experience at the end. But just to kind of give you a look and feel of what this could look like. So ultimately the provider’s going to come through, identify how they want to ingest their data. If they go with caqh which is always the most popular route, they’ll enter their three data points. It will confirm and link. They’ll then receive and update the caqh is now linking. And then they can go directly to their profile. So when they go to that provider profile, it’s going to look like this. So this is the provider’s view. They’ll have access to their payers to their licenses, overview includes the task and so forth. And then there is a checklist. If there’s anything missing such as agreements, it doesn’t have one next to it. They’ll be able to go to agreements, review the documents, E, sign again from their phone. From their tablet, go through each of these. I think there’s four save and finish. And then don’t worry. I didn’t forget the QR Code scanner. If we come back here to documents, then I’ll actually I’ll show you here. I can go into Naomi’s profile. I’ll go to profile documents and then upload by photo. So they can take their phone. They can scan this, take a live picture. They can also just upload from their phone as well. So maybe they’re on the go. I mean, it’s honestly, it’s just, it’s a lot of effort for them to find the document, find a printer scanner, email it to their admin, have their admin, send it back to josh and your team. And so, but yes, this allows them to take a picture of it. OCR technology scans, it saves the PDF, names it everything like that.

Josh Hartle (50:26) And if I could add here real quick too Mallory, if you could close the pop up just for Paul, in my experience, this is where I loved medallion when we had it at my last organization. Because if you see all these things on the left side, that’s your guys’ current packet today, so it’s all in here. So, it basically that’s where it’s digitized. And then secondly, you’ll see like here’s your disclosure questions. Are we in here? And if you go back to the documents tab, this is where I think medallion does amazing with their integration. We don’t have to like ckh houses like their malpractice, their license, yada, they send that over to us already. And so, therefore we’re not having to ask the provider for it. It’s already in this in here for us to review and add to their system. So it’s another again easier. Well, there’s no lift from the candidate other than adding their caqh and their social and link.

Mallory Smith (51:22) Exactly. And that’s.

Josh Hartle (51:24) kind of what we’re working on right now. We’re just to give medallion a heads up. We’re currently creating a group account with caqh because she’s once using that for our roster. And so that’s probably going to be a part of this. We’ll see how you guys connect that and just kind of automate that process as well. But I’m excited. I love that feature about medallion. Yeah.

Pholzak (51:43) So what we’re doing is we’re just like we’re not really siloed anymore. We’re kind of all like, hey, we’re all in this, we share the documents we use, you know, anything that needs to be updated obviously, but you.

Josh Hartle (51:54) Know picture.

Pholzak (51:55) Of the diploma is like that’s not changing, you know?

Mallory Smith (51:59) What I mean? Hopefully they still need that.

Pholzak (52:01) It’s a done deal. Yeah, yeah, yeah, yeah, no, I.

Mallory Smith (52:04) Appreciate the intel out there guys. Yes, josh. I’m curious, is it like you’re creating a practice manager access?

Josh Hartle (52:11) It’s called provider groups, practice manager is getting sunsetted. And another thing that’s helpful too with this Paul, they have external accounts in here too. So if they… want us to manage any of these external accounts like npps Pecos, or they can store them in here because I forgot my password. Well, it’s in here for us to save. So it creates just more synchronization… with everyone.

Pholzak (52:44) So this is the physician.

Pholzak (52:52) If it’s a physician, it’s their stuff.

Josh Hartle (52:55) Yeah. So it’s like if they wanted to keep a copy. So it’s like right there, like American osteopathic association board. I can save my username and password in medallion that way if I need to remember it, or for example, if I do need credentialing to manage it, I’m like, hey, you’re my credentialing specialist go in there and take care of it for me or medallion is going to be the designee whatever it’s all in here. And then you don’t have passwords going via email and all that stuff. It’s a secure way. I log in. I add it and then that’s done.

Mallory Smith (53:25) Let me ask you this, so.

Pholzak (53:26) I belong to the American osteopathic association. I don’t know. I got something from them in my email. I’m like, yeah, I want to go and I got to get into my account. I can actually come to medallion and get into my account from here. Yes.

Mallory Smith (53:47) Oh, yes. I mean, you have the ability of storing that login here. Yeah. So I could pull it up. Let me know the account type other. You can name it so they could store their Facebook password in here if they wanted to.

Pholzak (54:01) That’s cool. Yeah, it’s a.

Mallory Smith (54:05) Repository, right? So, like at the core of what we have at medallion, it is a repository. It is for provider data management. This can be your new ongoing tool for communication for cme tracking. It can be there’s a yearly flu vaccine that they have to get, it can all be notated here, right? So, not only are you getting the benefits of credentialing onboarding being two days enrollment, being an average of 51 days. You’re also getting a place for them to interact, communicate. And of course, everything is time stamped. So if you’re wanting to track how long is taking for task to be completed by providers, how long it takes for them to respond to the task before it’s completed all of that’s available?

Pholzak (54:45) To actually kind of just change what you just said to me just a teeny bit, which is the benefit to the provider is… that they can store all their stuff here. It’s a nice tool for them to be able to have medallion remember all of their association passwords and things like that, and it can track their cme in one place for them. So they, so this is a benefit to them of actually being part of this, right? So this is like not only is that we’re involving them in this platform to do the things that we need. We’re actually going to give them something back and say, by the way of being part of this process, we’re actually giving you a tool that’s going to be helpful for you to track all this.

Mallory Smith (55:38) Absolutely. It’s one of our cores here at medallion. We want to accelerate revenue. We want to also reduce provider abrasion. So that’s another big one for us. The provider frustrations of having to deal with this when they just want to treat patients day in and day out. This takes a lot off their plate. Yeah.

Pholzak (55:57) It’s.

Mallory Smith (55:58) a great way to look at it, Paul. Yeah, that.

Erica Lloyd (56:00) Was one of us a very large substance abuse clinic that was like a main value driver. It was reporting and then removing provider frustration. They’re like it is so sparse to have provider time and we need them treating patients especially because, and substance abuse, if they’re if they come to the door, they need a provider ready right then or, they’re gonna lose the patient and just taking as much admin off of their plate as possible was like a very big value driver? Yeah.

Mallory Smith (56:30) Perfect. I think we’re doing pretty good on time. Erica. How much time do you need at the end to talk about next steps? Do you have 15, 20 minutes?

Erica Lloyd (56:37) Yeah, yeah. Okay.

Mallory Smith (56:38) Awesome. All right. So then where we can go from here is essentially josh. I’ll actually leave it up to you for, well. First, let me make sure Paul, are you feeling secure and confident in how the onboarding process would work for a provider? Do you think would be a better experience for them? Any final questions before we wrap up that aspect?

Pholzak (57:01) No, I’m not feeling confident. We, we have a system initiative here. Okay, that is on our goals. However… we culturally, we need to define onboarding for physicians and apps, but we’re going to focus on physicians and that’s on our goals for this year and next year. The onboarding, the way we define it is cultural acclimation and providing support to the physicians as they stay… on and their tenure increases. Ideally, it would go out for a year. Ideally, it would be, it would be beyond what we call onboarding now, which in my opinion and by definition is orientation. Did you fill this out? Did you fill that out? Did we go over this? Did you go over that? Did you do this? Did you do that? Right? Our vision for onboarding is not that, it’s… you know, two months into your tenure here, you know, we know that it’s time for you to really get some pretty solid coaching on workday four months in. We know that it’s important for you to already have had a partner, a physician partner, a mentor or whatever we call it with you since day one. And these are the things that should have happened. You know, who to call for this. You know, how culturally we work, you know, how to work your way through the organization, going back to orion, going back to onboarding, right? That you, for the first two weeks, you actually knew where to park, that you actually knew where the bathrooms were. You knew, here’s your core number of telephone numbers that we know that you’re going to be calling regularly here are the names of the people who are going to be most important to you in your first two to three weeks, right? We don’t do any of that. So that’s when we talk about onboarding, just so you guys know culturally where we’re going? Okay, right? Orienting is just the stuff like did you get epic training? Did you, right? Did you have your password? Do you have your badge? Do you have your, you know, all your other stuff filled out the compliance stuff? It’s not, it’s not the way we’re going when we talk about onboarding? So just so you guys know.

Mallory Smith (59:39) Appreciate that. So then in your words, what would you call the process disorientation? Okay. Yeah, compliant stuff.

Pholzak (59:48) Yeah, it’s not and no disrespect to them. It’s just that it’s not.

Mallory Smith (59:58) Well, I’ll tell you what? Yeah.

Pholzak (59:59) Because if you go to Amazon, you go to zappos, you go to netflix, you go to other organizations and you look at their onboarding process, it has nothing to do with, you know, did you fill out your paperwork? So?

Mallory Smith (60:12) If you end up signing and partnering with medallion, I’ll be sure that I tell the account manager that it is orientation that they are not allowed to say onboarding when we talk about this one. Okay?

Pholzak (60:23) It would be helpful to just call it orientation. Okay?

Mallory Smith (60:26) I’m gonna try my best to remember, but now I feel the pressure now, I’m gonna know, I know, I’m gonna mess up, you know? Okay?

Pholzak (60:31) I think it’s gonna take a long time to unwind people from that definition.

Josh Hartle (60:35) Okay.

Mallory Smith (60:37) Sounds good. All right. Well, thank you for the feedback. So, josh, we’re gonna do enrollment next. Do you want the credentialing delegation first or do you want to see standard non delegated enrollment?

Josh Hartle (60:50) Yeah, we can do delegation. I think that’s fine then. Okay, one thing I also want to say, I think that’s helpful is I see on your menus, you have facilities and groups. So providing enrollment really drives that whole process internally with carilion, where we have limitations right now with our facilities. Like, you know, we have to revalidate our facilities every so often. That is not a standardized… way of being tracked right now at carilion. So, we’ve had some close calls before where we almost missed some revalidation?

Mallory Smith (61:22) Deadlines?

Josh Hartle (61:24) And, which obviously, that’s a trickle down effect because then we get unenrolled and then we don’t get paid. So, and that’s something that we’re going to look forward to with facilities. And then groups can get a little just understanding our structure a little more. And this may or may not affect enrollment, but we may have… we, our epic team will be in this a lot too. And we have basic epic ids for say we have a rural health clinic. It’s technically a facility, but we may have 10 departments underneath it. They all have their own epic id. So therefore it’s a different type of group. And so I’m assuming that’s where groups will fall and that will impact our enrollments and then our naming configurations and all that. So all the same excited for that. I think with monitoring that’s kind of even with our delegation piece. We even had it this week. We had a provider that was involved in, a malpractice case, and they just settled it because they didn’t want to go through the whole trial process. We have to report that to the payers. And so right now, the manual process, we’re really depending on people to notify us of that happening. And again, we haven’t had any misses yet. But that’s another thing I think we’re looking to see how can we really streamline that? And we even have third party providers that carilion will outsource to. And obviously we’re still held accountable for those providers too. So they’re currently in our Symplr system, they would probably be in our medallion system even though they’re like a third party provider.

Mallory Smith (62:48) But.

Josh Hartle (62:50) kind of wanted to give those things at the front end that before we start getting into delegated non delegated because they kind of are related to that whole process absolutely.

Mallory Smith (62:59) I definitely think they are related to your point. So what I would say if you wanted to track third party providers, you track them, they would have a core seat in the platform. They would be able to interact as much as possible. We would just restrict them to a certain team. So we would call them external third party, whatever you prefer. As far as the configuration that way they are easily identified in the system that these are not actual W to employees of carilion. So no issues there when it comes to ongoing monitoring, I did actually build… a visual if you will. I can send it to you after the call regarding ongoing monitoring. So do you, currently, are you set up with the npdb as an organization, so.

Josh Hartle (63:40) Ccvs is the team that handles that. So it’s that’s kind of where me and Paul, we work very closely together because they’re the ones that are driving it. But we’re the ones that are kind of reporting it to the payers and anybody else that needs to know about it externally. And ccvs is more focused internally with, all right, I need to let the committee know. We need to let everybody HR know. And so it’s kind of a we’re in this process in tandem. So, yeah, absolutely.

Mallory Smith (64:05) So in that case, we are comprehensive in the monitoring. We can set up an established continuous query for npdb, all the big ones that I call like the ncqa compliant on ongoing monitoring. So, Sam, oig, medicare opt out, medicaid exclusion, things like that. When you do find have something come back for the provider, alarm bells all over, right? So the provider will be notified, your team will be notified. You’ll be able to click into it, even see the explanation or the event that occurred. If it was a settlement, if it wasn’t then they went to court, if it’s pending, if it’s been closed previously. So you’ll have documentation of that in the system automatically as well. So that is a conversation you want to talk with your I’m sorry. Did you say ccvs?

Josh Hartle (64:50) Ccds pro, end credentialing and verification services? Okay?

Mallory Smith (64:53) Thanks mouthful. So if you wanted to have that conversation and just let them know that this is something that maybe the vendor they’re currently using for it or we could just do the monitoring there, API it into the medallion platform. There’s all kinds of options we have there. Okay. Cool. I appreciate you calling it out though, but yes. So facilities, if you’re missing revals with payers, of course, then you’ll be able to easily see them. We have the providers that are rostered. We have the payers, if their revalidation date, their current effective date, all those data points, you would look to track exact same at the group level. So if I were to go into an outpatient here, look at the payers, active enrollments, billing status. We can get as granular as the effective date for that line of business with that practice location. So not every customer typically needs that level of granularity, but we can do it. And this would also be just a central source of truth for your payers, their revalidation, you’ll get an automatic ping when it’s 90 days before you can initiate that process. We can do that process for you either way. Okay?

Josh Hartle (66:02) And make sure we’re talking apples and apples. What makes this a little complicated is you guys are likely aware of this being a health system. We’ll have obviously our facilities, but then we’ll have like hospital outpatient departments that are technically a group, but they’re a part of the facility kind of how do you guys structure that in the system?

Mallory Smith (66:20) What services would we be providing with those in mind?

Josh Hartle (66:25) So it might be like an asc like an ambulatory surgery center, things like that typically.

Mallory Smith (66:34) Ascs, we would keep at the facility level, the reason for that. We could do facility enrollment. We can do hospital applications. We can do joint commission level privileging if that’s required as well. But that would probably be the facility level if you’re not doing anything facility related to the asc but you’re just wanting to track it for purposes, then you can store it at the group or the facility. So when we’re going through the implementation process, we would be able to show you and let you know like here’s the preferences here’s. What we commonly see. But we can work to your standards.

Josh Hartle (67:04) So you follow the facilities and group definitions somewhere like mpps, like if it’s either single specialty or multi specialty goes in their group, if it’s a facility like rhc or hospital, it’s a facility. Okay? Just wanted to make sure, didn’t want to assume no of.

Mallory Smith (67:18) Course, I mean it’s really, it’s up to you that’s how we have our definitions, but we absolutely have customers that have different. They insist on their hospices being a group instead of like a facility because they do facility enrollment. That’s fine. We’ll make it work either way. Cool. Okay. Perfect. All right. I’ll just take 10 minutes. So, sorry, Erica, I barely leave her with any time every time but I’m going to run through first, of course, we would get your payers list. We do have an internal payers directory with over 1,200 payers nationwide. We do have roster features when it comes to submitting the application. We have, let me see if I can just go into this one. If I were to pull up medicaid of New York. For instance, this is what our process guide looks like. So, of course, we’ll have the common information like the Nhi that you gave me earlier. We would have a field for that. The process guide. This is how our team essentially is a workflow engine, would go through and populate the applications, get them submitted, whether it’s via portal automation and submission, or if it’s PDF. And then based on the service type you’re looking for… it’s, going to show us exactly what prereqs dependency, if needed the application, if it’s a two step multi factor authentication process application steps. It also includes the follow up cadence on what’s needed, the required documents. If there needs to be an escalation, we include an escalation pathway. And this is built again for 1,200 payers across the nation. So very… thorough is what I would say is what our workflow engine basically feeds from. And then we have an intake process for each of these different payers per the provider type. So we have a payor research team that is basically their sole job is to kind of handle that aspect of it. And then when we think of just the visibility, everything that I’ve shown you in the system is exactly what your team would see and experience. So we’re full transparency. So where we may step in and complete the work on your behalf, submit it, do the mundane work to Paul’s point earlier. Then your team at least has that higher strategic level. You’re able to view every email, every submitted documentation, every app, every welcome letter, it’s all stored within the platform, every task where we talk back and forth with providers and actually AI in mind, we have an email parsing system. So we are a cbo, we get 2000 emails a day. We use AI to go through. Automatically flag those emails when it comes to the inbox, attach it directly to the payer line that you see here. If it needs a quick 24 hour, 48 hour turnaround time, it then creates a task for our specialist to grab immediately and act on it. So it’s automatic email parsing as a part of the AI feature. And then otherwise you can basically just come through the request scroll to the right, see any information that you need. The request status. We of course see a visual tracking piece here within the SLA, what’s the follow up date? Just examples like that.

Josh Hartle (70:22) You know, this brings up a question. This might be big for me and Paul because I don’t know if this is possible or not. So we have what’s called the provider information form that is filled out. And so right now, it’s imagine this. It’s still PDF. We’re trying to get it where it’s digital. But typically, when the pip is submitted by typically the practice manager, it gets approved by my team, Paul’s team. And then maybe one other team. Is there a way for us to kind of conceptually put that in here? Where like for example, Paul’s a new provider. I think that process is easy to kind of get that in motion. But say he’s adding a location or I’m going to add this location, take this location away. Is there a way for us to kind of create a workflow for that? Where it’s using our standardized group and facility information which will have our epic information. And then it goes through an approval process for me, Paul and whatever other teams may need.

Mallory Smith (71:18) And then, right?

Josh Hartle (71:19) Now, where we’re kind of getting stuck is like it’s not standardized like the selections on the form. So there will be errors. And then we have to send back to the practice manager for correction. And that’s kind of where stuff’s getting lost right now. It’s like, okay, well, then how do we get it back into the approval process? Do you guys have a solution for that we?

Mallory Smith (71:37) Do it wouldn’t necessarily be your team’s responsibility? Let me show you what it looks like. And then.

Josh Hartle (71:43) That’s a huge pain point for carilion right now, whether it’s new providers, maintenance of our existing providers or even letting providers know they’re leading the system. Sure, yeah, of.

Mallory Smith (71:54) Course. And like for providers leaving the system, we have a term option. It has a workflow enabled. So it’s going to go through and turn everything off for that provider, including the seat for a new provider. But let me show you what your team would be doing to interact with the platform. And then as a follow up, if you wanted to send me that pif, then I can let you know the specific data points and if we already have them baked into the system, okay?

Josh Hartle (72:18) Does that make sense? Paul, what I’m kind of thinking there? Sure. I didn’t even think about it until as we’re looking at this because then it trickles into enrollment, it trickles into credentialing, privileging. So if it’s already in the same system, that would kill multiple birds with one stone.

Mallory Smith (72:35) Okay. Absolutely. So someone from your team, if there is a demographic update, if there is a new enrollment that’s needed would go to request, click new payer enrollment and then let us know if it’s for a group provider facility or comprehensive, identify the provider. Let’s just go with Naomi. We’ve been sticking with her, the group. So we already know intuitively that she’s a part of these groups as identified in her profile. If you needed to add additional groups, you just go to groups and then type in her name and add them or you can go to her profile and type in the group name. So it’s bi directional. And then from here, identify the payer state. So again, intuitive, if the provider does not have a license in that state, we can’t submit enrollments. So if I were to come down here and say, hey, let’s submit to Alabama, then it’s going to have big red letters and say, hey, this provider does not have an active license in Alabama. So if I said Louisiana, we’ll identify a payer with one click, I can highlight all the plans that are part of that tax id or if you have a provider that’s specific to, they only need 10 out of the 15 plans or something of that nature. You also have the option of just clicking one by one. So completely up to you. When we think of that, are we going to use the same lines of business for all payers? Yes or no? If we say no, then we’re going to come through and identify and for these individuals, it’s only commercial, but you would also see medicare advantage, medicaid, if there’s any workers comp associated. So you do control the request itself. From here, you just go to next, identify the practice locations. If we’re using the same one for this entire application or not identify… it from the list demo provider. But want to say this one and then next is going to go through the application details. So do we want this to show in the payer directory, desired effective date? And then finally any final notes that you want to give our team, when we receive this request, it’s going to head to our intake process. So you would see has been requested. And then what our team does on the other end, if I go to providers here, let me go go into Naomi, see the, what we call mission control. So our end received… is going to basically verify every aspect of what’s needed for that payer. So that internal payers directory I showed you earlier. This is our intake piece right here. We’ll give it just a minute. I was moving too fast forward, but ultimately, with the intake process in mind, we’ll make sure that we already have the documents on file that the license is active, that we have a Coi for the provider as well. So it may or may not be. But if I were to look for instance, there’s one in process right now for blue cross blue shield. If I open that up, we’ll know like, hey, we have 28 out of 31 items that need to be completed, 14 out of 18, zero out of two. So this is how our team and the workflow engine tracks it. Okay. So that’s the flow. How does that compare? I?

Josh Hartle (75:53) Think that’s great from an enrollment standpoint, but I think where it gets complicated is I get this one request, it triggers an enrollment workflow, it triggers a credentialing workflow. It triggers a privileging workflow. And.

Pholzak (76:08) So, because if.

Josh Hartle (76:09) it, if they’re going to like a new facility that requires privileging, then policy has to handle that. We have to send them a new delineation of privileges form. And so it’s kind of like it’s not just limited to enrollment. It’s kind of like five teams like even epic team will have to maybe do something.

Pholzak (76:26) So,

Josh Hartle (76:28) that’s kind of maybe that option doesn’t exist today, but that’s kind of where we were thinking. I was thinking with that. I,

Mallory Smith (76:36) think I see where you’re going. I would probably say that to initiate that quote unquote workflow would be your team making the request in the platform and then Paul for your team, then you would come to privileging and then you would make the request here. So that’s what’s initiating the workflow. So your team would still be responsible for requesting enrollment requesting cred, requesting privileging. We’re going to do the actual auto population submission and follow up, but then your team is still getting that overview, tracking the analytics and handling any escalations, white glove service for providers. So I can definitely go through maybe on a future call where we identify what is your team responsible for versus ours? But I think it would still be three separate workflow kickoffs, if that makes sense.

Josh Hartle (77:24) So, that would probably still live outside of this system, okay? And,

Mallory Smith (77:28) you want to send me that form and I can run by our product team and see this is something that.

Pholzak (77:33) we’ve.

Mallory Smith (77:34) thought of or building out, just let me know the data points and things tracking. Okay?

Pholzak (77:38) Thank you. Okay. So a couple of things kind of shifting gears a little bit.

Pholzak (77:50) What’s the impact? What’s the impact on the staffing there?

Mallory Smith (77:55) Will be an impact. Yeah, how much of an impact is really? It’s within your control? Erica, I’ll let you talk to just how we kind of handle staffing there of course, because so much of this is automated, there would be an opportunity for you to downsize but, and.

Pholzak (78:11) then, and then… that too timeline to implement. And, and the reason I asked that we’re… like, okay, great. We’re gonna move forward with this, right? Well, it’s not like we’ve involved everybody from the get go here. It’s gonna be like what? And so josh and I are gonna be looking at like people are gonna be like, hey, I’m out of here, right? You’re gonna reduce me and we’ll be like, I don’t know if that’s gonna happen. They’re like, well, can you tell me it’s not gonna happen? And then we’re gonna be like, no, and then people are gonna be like, I’m out of here, right? But I’m concerned about that piece of it which is what’s the timeline for you guys to train our folks, what’s the timeline in terms of them coming up to speed and this being able to be effective and efficient when people do leave. Yeah. And on the flip side, if we’re gonna pay you to do this and people are going to, actually, we don’t need everybody, right? If we’re displacing X amount of people and we know how much we’re paying them, right? What’s what’s that going to look like? In terms of, well, we moved the dollars from here to here. I don’t think we’re in here. I don’t think, I don’t think this conversation is revolving around cost savings. I think this is revolving around, you know, let’s be neutral on the spend but let’s just do what we’ve all been talking about here for a while, which is excellent canned experience bringing us into the first century, making things really effective, you know, introducing AI.

Mallory Smith (79:50) Yeah. So I’ll take a quick stab at it and I just want to speak from personal experience we have in my tenure here, we’ve had maybe four or five customers that have been in that situation where they, their staff was sensitive to the idea of partnering with someone else. Most of their staff was not aware. What we’ll do on our side is we’ll actually build out an implementation project timeline with you where you’ll be able to cut. There. Is there’s one I have in mind, they had eight ftes, they wanted to reduce down to two ftes by month four. And we were able to basically take away two ftes per month and how they were able to get down to that. So we can absolutely build that out with you. We would have our head of technical solutions do a scoping project with you get an idea of just the volume of data to migrate over. And then really once the data is migrated, the training is it’s minimal when you think of what’s needed with the platform, but that’s all part of the implementation process.

Erica Lloyd (80:46) Yeah. I think, Paul, you’re absolutely right. I mean, I think there definitely would, I mean the goal is to have either one, you know, not continue to hire as you grow. And then two, yeah, shed some staff and that’s typically they’re kind of the value driver saying they’ve reduced margins but also reducing some opex, some head count. And that’s probably why there is the automation initiative. Yes, candidate experiences is really important especially with providers. But like we, that’s where we’re going to come up with some margins too, is reducing some staff. So I.

Josh Hartle (81:25) don’t know if I can speak for Paul on that, but I think just where carillion is… we outsourced our RCM function about a year and a half ago. So that’s very fresh in a lot of people’s mind. Like we even had a phishing email that Paul, our VP of HR had to send me out because it was a phishing email and it was like, hey, can you take a look at this file real quick? Because here’s a list of people getting laid off and it was a phishing email, but it was just bad timing of how it went out. So I had to send out an apology email like, hey, this was a bad use case to use for it. So I think that’s something that even in my team, I deal with a lot and.

Pholzak (82:04) we would.

Josh Hartle (82:05) Like to, it’s going to be a delicate walk we have to have because.

Erica Lloyd (82:10) even.

Josh Hartle (82:11) if we can repurpose them elsewhere in the organization, I think that would be kind of like a nice Olive branch to have, hopefully our teams will be mature enough to approach that versus like peace out, screw you and whatnot but yeah, I think that’s a big piece that the organization is going to want us to focus on too while reducing our costs even though that’s not the main driver, you know? Yeah, you.

Pholzak (82:35) Get a cost… thank.

Erica Lloyd (82:40) You for asking. I was glad you, I was like, I, I’m like let’s start getting there. But yeah, so essentially, because we showed you, we showed you a lot of different modules. So we have a consumption based model. So we would need to just know exactly what you would want in scope and how much work you’d want us to do for you, we can send you a, we can send that over to you and then kind of review it live. What exactly in that one for our proposal and then we can kind of walk through.

Josh Hartle (83:07) That I.

Erica Lloyd (83:07) think that’s a good you?

Pholzak (83:10) Know, just, yeah, just obviously, there are questions, right? Or things for us to, like tell you what we need or what’s going on. Yeah, like.

Erica Lloyd (83:19) If you’d want us to help with the delegated credentialing or if you’d want to keep that like which pieces because, yeah, because it’s we showed you a lot of different products and then we can go through it live because you might be like, wait, which one was that?

Erica Lloyd (83:30) Again? Do we want that in scope? And it’s also going to have to do a lot with like forecasted hiring because we don’t charge it. You know, we don’t charge for admin users because there’s minimal users, but we charge for seats. So it’s like, okay, what’s your forecasted provider hiring? How many plans are they going to be enrolled with? Which skews? So we can send over for that information. And again, we can do like a mix and match approach. So you may not need everything and that could, we could say like, okay, this could impact this could be an impact, but, you know, the cost, the cost is here.

Josh Hartle (84:09) I think the.

Erica Lloyd (84:10) other thing, is from a timeline perspective like this would like, it wouldn’t make sense to have the two systems like having Symplr like obviously you’d have, the onboarding system workday but you wouldn’t need Symplr also. So we would probably want to work through timelines of like when you’re up for renewal and then reallocate some of that spend is probably a lot where we’re going to come up with budget here in addition to, you know, if they’re shedding some reallocating some ftes, but we can talk about like what a, if what a data cut over would look like, great.

Pholzak (84:44) Yeah, that’s great. Do.

Erica Lloyd (84:46) You happen to know, josh, do you happen to know what you’re spending on Symplr today?

Josh Hartle (84:52) Unfortunately, I could think of ballpark, but I don’t want to give numbers out that aren’t I’m not really aware of. Yeah, I.

Pholzak (85:02) don’t know either. Yeah.

Erica Lloyd (85:04) I.

Pholzak (85:05) mean, obviously, we’ll talk about it, right? You know? Yeah, I mean, you know, send us the information. We’ll go through it, you know, and then obviously, we’re gonna have to go back and then talk internally about this. I got some moving parts with Symplr and some other stuff going on. So, yeah.

Erica Lloyd (85:24) Always, but yeah, just so you can understand… the, very strong man here but timeline, I think sorry, this should actually be in. This should be a 10 week. We will, we can talk further about what that looks like from a timeline perspective, but, I think josh, you said it, was it in the fall that you’re up for renewal with Symplr? Yeah.

Josh Hartle (85:56) No, I know we have some, we’re working on some like some deadlines with them, but I don’t think that has anything contractually. I’m not quite aware of the renewal.

Erica Lloyd (86:07) Okay. Because we would want to give you at least minimum of like eight to 10 weeks for a cutover for like the time you sign the contract until, the cutover and we can work through the step through approach of what that would look like. But just from like a data perspective that’s for?

Josh Hartle (86:26) Yeah. Well, that brings up a good point because our medicon director, I’ve told him we’re having these conversations. He was curious, is there a way for us to bring in any historical data over that you guys can add within your dashboards and everything to kind of make it where we, we’re not losing year over year, trend data even if it was not, what we wanted but it’s still better than nothing. So we can track improvements and trends, yes, absolutely.

Mallory Smith (86:53) I think that’s our priority number one honestly is historical data because we don’t want to start from scratch. It’s great for new providers that they just get out of the system. But, the source of truth that you currently have now, we never want to mess with. So, yes, we will probably bring over historical. Okay, cool.

Josh Hartle (87:10) So, like for example, I could look at, we could import all of our data because I think we’ve been using symplr since 22 23. So we could, we bring all that data over. And I could then like a graph of like the past six years of where data’s been? I know it’s not been six years but, yeah.

Mallory Smith (87:26) You can and that’s just because of my previous tenure, you can unarchive everything and they’ll be able to export it for you. Yes. Okay.

Josh Hartle (87:34) Cool. Awesome.

Erica Lloyd (87:37) Questioned. Okay. So appreciate the time. I know it’s a long session. So, great question. No, it’s good. Thanks so much for the interactiveness. I guess like based on this, let’s do you want to continue moving the process forward which would be going through the proposal? Yeah, I think that’d be.

Josh Hartle (87:54) Good. And that way, I mean, Paul can be prepped because obviously, we’ll have to talk in terms of our VPS and hire and hopefully keep the ball rolling.

Josh Hartle (88:02) And once they give us screenlights, we’ll probably have more stakeholders that get involved to do more demos and make sure we’re on the same page, yeah.

Erica Lloyd (88:12) We would love to meet you guys in person and other stakeholders who can come down to Virginia. We’d love to have lunch or something. Yeah, that’d be awesome. That’d be awesome. Cool.

Pholzak (88:21) Where are you guys located?

Erica Lloyd (88:24) I’m in New Jersey? I.

Mallory Smith (88:25) would come up to Virginia. I’m in Nashville. Oh, there you go or y’all can just come to Nashville and I’ll show you broadway.

Josh Hartle (88:34) There you go. That’s awesome. Do you guys want to get a meeting on the books for?

Erica Lloyd (88:39) That, yeah, let’s do that. Let’s do I’m actually going to spring break with the kids next week? So, can we do the week of the sixth?

Josh Hartle (88:53) I will be, I?

Pholzak (88:55) Will be available either Thursday, Wednesday, Thursday or Friday just depending on when? Yeah.

Josh Hartle (89:02) I’d say Wednesday or Friday would work better for me, okay?

Erica Lloyd (89:05) How about Wednesday at three 30 eastern?

Josh Hartle (89:10) Okay. Yeah. So I.

Pholzak (89:12) already need to muddy the water here. But so my Wednesday, I can tell you when I’m free? Yeah, when it’s free, I’m free before 10 30. Okay. I am free 12 30 to one 30 and.

Josh Hartle (89:26) that’s it. Okay. Wait.

Erica Lloyd (89:28) Sorry, you said 10 30 you’re free?

Pholzak (89:30) Let’s see. I am free anytime before 10 30.

Erica Lloyd (89:35) Okay. Let’s do nine.

Josh Hartle (89:38) Eight seven. Oh, I.

Erica Lloyd (89:39) have a conflict there. Let’s look at Thursday. What do you have open on Thursday? We could, I could do, we have open from three to five and then pretty much before… like nine to two is pretty much open. Also on the ninth. I.

Mallory Smith (89:56) Can work things around too, Erica, if that’s what you’re worried about. So I’m free.

Pholzak (90:01) Nine to 10 on Thursday or earlier. And then at four to five, actually, I can’t say five, I have to go to like let’s.

Erica Lloyd (90:10) Do nine a. M? And what we can do, is we can go through this, the scoping, hopefully, we can put a proposal together with that, but we may have to go through some of the, we may have to walk through some of the scoping live, but hopefully this can be, we can go through some pricing and I also want to just go through the project plan also a little bit from a timeline. Does that sound good?

Pholzak (90:35) Okay. All right.

Erica Lloyd (90:37) I’ll send an invite, and then I’ll send you, we’ll send the scoping questions as a fast follow. And then is there anything else that you want from a lead behind perspective?

Josh Hartle (90:49) I think that covers it.

Pholzak (90:52) Yeah, sounds good. Well, appreciate.

Erica Lloyd (90:53) The time. It was good to see you both.

Mallory Smith (90:55) You guys too. Thank you.

Josh Hartle (90:57) All right. We’ll be in touch. Thanks.

Erica Lloyd (90:59) Bye.

Pholzak (91:00) Have a great weekend.

Mallory Smith (91:02) Oh, you too. Thanks.