Transcript
Alex Lawrence (00:00) hi, Anna. Happy Monday. Hi.
Anna O’brien (00:02) How are you, Alex?
Alex Lawrence (00:03) I am doing phenomenal… super excited to connect here and just kind of learn about what you might be looking for, see if things align and kind of go from there.
Anna O’brien (00:16) Cool. Yes.
Alex Lawrence (00:18) How was your weekend? My?
Anna O’brien (00:20) Weekend was good. I’m in North Carolina right now with a, my kids are home. So it’s a little chaotic and hopefully we won’t get interrupted about my parents’ house. I’ve got a dog like tearing ass around, excuse me?
Alex Lawrence (00:36) No worries at all. Well, yeah. As I said, kind of the purpose of these initial calls is just kind of find out a little bit more about what you might be looking for, share some more about medallion, if things look like it aligns would get you set up with an account specialist who can do that kind of deeper dive into what things would look like for you. Okay?
Anna O’brien (00:58) The best way I can start probably too is like giving you a heads up that this is going to be a really probably a unique use case for you guys, which I think could be really exciting, but we’ll have to kind of work through and see if it’s something that would be possible. And if it, is something I imagine that you would want to discuss with your team if they’re like kind of interested in piloting something.
Alex Lawrence (01:20) Okay.
Anna O’brien (01:21) Okay. So I run co, working spaces for therapists and we have, we’ll have eight locations by the end of may or beginning of may in the Philadelphia region. So, we support private practice therapists who are really truly own their own business. So it’s not like an Alma or a headway. And they, we provide flexible use office space as well as a lot of networking and marketing support through the membership. So, we do a lot of events. We have webinars on marketing. We support things around that. And this year, we have also formed kind of an alliance with other therapist owned co, working spaces in Houston, DC, Atlanta and Chicago that do similar things to what we do. We use that to kind of share resources and, you know, their strength in numbers of ability to like, you know, add on extra webinars, and whatnot. And so when we’re rolling things out, we are able to combine all of our memberships, you know, and split costs on things and whatnot. So there’s been a strong interest from therapists recently to not go the headway or Alma model where they’re actually just part of a group practice, but instead get credentialed on their own. The concerns that are typically raised by therapists are that it’s time consuming. It’s confusing. They aren’t sure what the rates if they’ll be able to have power to negotiate better rates, which is often why Alma and headway are succeeding in some ways, but a lot of therapists are not wanting to do that route and want to truly remain independent. Ugh. And hold on. I’m, do you hear this in the background? Yeah, you’re fine. Okay. So, that is the use case. Are you available in like five minutes? Can you hold on? Okay. I’m sorry, my little dog ran away and that’s my kid’s screaming, let me know. I told you chaos would ensue. So, I’ll be back but I hopefully gave you enough and it’s bewelloffice, com is our website. So, okay. Yeah.
Alex Lawrence (08:23) Welcome back. I know how that goes. It’s funny. My, my dog has passed away, but I used to, I used to leave him outside and forget about him. And like the house that I used to live in had an acre and I would be in the middle of meeting. I’m like standby, I need to go let him back in. And luckily he always came back. But, I feel that okay. So, so looking for people to do like credentialing on their own. It’s definitely a unique case. The, the one like big I guess overlying thing is we have transferred into a more enterprise level setup… one of, the difficult things and obviously like it is unique.
Alex Lawrence (09:19) So, I would definitely run it up the ladder just to see the problem is we don’t really do pilots anymore because the implementation is so difficult. There also essentially needs to still be a host if you will. We’re not like really set up for just individual people just to come on and do it themselves. We definitely simplify that. I would say like the closest thing… I guess the closest kind of business case would be we work with a lot of like primary care associations. So they ultimately are the org that we work on, but they may have members and the members go underneath there.
Alex Lawrence (10:02) But there has to be realistically like, a… amount of providers that are all 100 percent in and we do have like an upfront annual spend. And I think that would be the struggle there is like the gathering, how many people are 100 percent in like where they would need? It? Is everyone on board or if it would just be like, the, like your guys’ business is essentially taking on and paying an upfront fee of like these credentialing. And then people being members to you guys would utilize them underneath that umbrella. And that’s kind of like that I think would be the biggest struggle is because it would be a substantial upfront fee. And so if a bunch of people like didn’t move forward with it or they wanted to go a different route, that would be kind of where you would get left like kind of hanging in the wind. So. I’ll leave that kind of there. Like I guess one big thing like how many providers total, would you say like fall underneath you guys? What does that look like?
Anna O’brien (11:13) Yeah. Well, and that’s so maybe 500 total, but like not everyone’s gonna, some people are very happy being private pay. Some people are already credentialed. I think that what, and enrolled, I think one of the things that we would really see a benefit in this is like that it would be a membership, it would increase membership for us. So like I’m not opposed to discussing or at least getting an idea of like what would the minimum upfront cost be? And up to how many credits would we get for that? So that I could go and see like, is this a worthy investment for me to split between everybody? And then we can decide how we price, you know, that service?
Alex Lawrence (11:57) Yeah, it, and, I will be transparent like, our annual spend starts at 50,000 and it goes up from there, it is, I like to articulate it as an a la carte setup. So it’s not a universal. Like this is X y Z. Like, if this clinician needs cross state licensure or they need to be enrolled with Aetna blue cross et cetera. But this one just needs to be like essentially credentialed if you will like depending on what their needs and stuff are in the scoping process, they break all of that down. So that would be like a I can’t necessarily quote. I do know like what our minimums come out at… but I think more than anything, I would want to kind of fire this up the pipeline of just seeing if it’s something that like we would be able, to take forth in.
Anna O’brien (12:57) Yeah. There’s a go ahead. Sorry. Oh yeah.
Alex Lawrence (13:00) Mainly because we just to give an overview. So we’re an end to end solution. So essentially, we partner with orgs who are looking to scale without headcount or to reduce headcount of like a credentialing team. So we accelerate the time to revenue through automations and relationships with like payer enrollment like orgs as well. We just the sheer volume we do kind of we can develop packets and whatever have you to kind of get these clinicians through the door and billing quicker.
Alex Lawrence (13:37) The problem when we kind of run into these like pilot things is it sounds good in theory. But then to your point, like some people may just be like, you know, what I’m actually easier just handling my stuff just individually as a one off scenario. So it’s like without the full buy in sometimes like the self service software ends up being like an easier setup. I do feel if you have 500 providers, if even if you had, I don’t know, I’d say 30 that were on board. Like there’s definitely a volume there, but to that point, it still would have to be like charging them a premium to get like your money back.
Anna O’brien (14:23) Right. Yeah. And I had, yeah, I mean, it’s and therapists are very frugal, like very frugal. Our reimbursement rates are lower, you know, so there’s only so much too. That like I could like that’s why they’ve done the almost in headways. So there’s an appetite on paper for them to get independently credentialed. But then it’s like, okay, the pass through cost ends up being, you know, 3,000 dollars for the, each individual therapist. I don’t know if they would bite on that, you know? Yeah.
Alex Lawrence (14:57) Yeah. And that would, and that would be like trying to be protective of you. That would be like, my concern too is on paper say you have a bunch of people that say they’re down, but then they start like doing the math and they change their mind, you would have already had that initial investment. And like the last thing like we want people to be excited about like being partnered and not feel like they got stuck with something if that makes sense, right?
Anna O’brien (15:25) Right. Yeah. And so I mean, right, it may not make sense. So it may be an issue like a matter of like if you know, of some smaller companies that are doing more of this type of work that you would have a referral for that would be cool, or if they, when you’re talking to your folks, if they’re like open to doing this because it does fit that model of what you mentioned with like the associations. But I think what we would need to know is like a clearer like basically what ends up happening is most therapists would probably want support around getting going through the process of credentialing and enrollment and whatnot, but probably would only choose like up to six, you know, insurance, right?
Alex Lawrence (16:09) For sure. And with, yeah, and with like kind of our setup. So we have a direct integration with caqh. So we are pulling a lot of the profile information. So it decreases provider abrasion, it accelerates… through that. Whereas you have a clear checks and balances of like, hey, this still needs to be verified, this has submitted. And so it simplifies for the provider as well. And it can be custom tailored. But I think like the one big thing is it would fall, you essentially would be like the overseer of everything and then we would kick off whoever like wants to go on and down and so forth and stuff like that. So, yeah… and I.
Anna O’brien (16:56) would imagine like if they had any flexibility, like if this did, if they were like this is something we want to entertain. One thing I probably would want to know is like, can we have flexibility on like the initial upfront payment? Like if it, because usually these things take a little while to kickstart. Therapists are a bit like they operate in a bit of herds like they, they’re slow to try something out. And then once there’s buy in and there’s social proof, then all of a sudden, you get a lot more. So my concern would be like that first year, like even if this was swimmingly successful, it may take us the first six months even to get folks like doing it. So, I would want to know like would there could there be some flexibility around like when that 50,000, you know, could go until when it would expire. And and again, you guys may be too established to want to entertain something like this?
Alex Lawrence (17:43) Yeah, I was going to say, my big thing is, I don’t think there’d be flexibility like the, as I said, the implementations are so labor intensive that like we have steered away from pilots because you could spend all of these man hours and then realize this isn’t actually like what we were looking for and then they pulled the plug or vice versa. And those are more rarities I would say, but it is kind of like, I think before I even started the company, I think we were doing a lot of pilots and it just like was not the best use of time.
Anna O’brien (18:21) And.
Alex Lawrence (18:22) yeah. Those would, those would be my things. I know the flexibility portion like the upfront payment. I don’t think there’d be any flexibility there. The one thing though is like when they’re doing solutioning and they’re trying to get the most accurate forecast of like what this will cost for you on a per year thing. Say you do a multi year deal like a two year deal or three year whatever have you, the credits can roll over. So say you’re a little overzealous on the first year and you’re like I think we would get 100 providers out of the 500 bought in and your first year, you’re only at 50 those extra credits or whatever have could roll over if you think that like it would ramp through there.
Alex Lawrence (19:07) But those are all kind of that’s above my pay grade. Those are like what they try to figure out in the solutioning, but I just know, I’m trying to think of this like unique scenarios of stuff we’ve worked in the past, and like transparently, I don’t know, I think there would be better options especially if you just had like a self service that they could just hop in and do themselves. Because essentially with medallion like we’re software and a service. So we have a cred team that’s knocking out stuff and so we simplify it for providers. But like if they’re just trying to come one at a time and we don’t know exactly who 100 percent needs to be there. It’s like you may end up managing a pipeline of people, and trying to tell us who needs to be kicked off. Because essentially, we would still rely on like you as an organization to let us know who needs to be kicked off and like what of each thing. So it may just not be realistically like self service may actually be the move. But I’m I am more than happy to like reach out to like my higher ups, and kind of give them an overview and see if they think it would be worthwhile. I personally feel like there could be better options at this point in time. Yeah. And then.
Anna O’brien (20:26) I really appreciate your transparency there. And, yeah, I’m sorry, I didn’t mean to interrupt you but like if, that makes sense because I like, I’m like I, I’m pretty innovative in my thinking but I often like sometimes it’s like that part of like there’s a, there gotta be a reason why people aren’t doing this already. So, you know, I may be bumping up against a bit of that. But I also think sometimes whether where there’s like creativity, there can be an interesting solution. But I get it. What you’re saying like with a company that’s like larger like this, you guys kind of have your tried and true processes. You’re not in startup mode of trying things, but if you have any ideas, like if you talk to your folks and they’re like, yeah, this isn’t for us. If there is anyone y’all know in this space who’s like looking to be creative because these co, working spaces are taking off like crazy right now. Like they’re everywhere. And so, you know, the model of how therapists are practicing is very different. And I think that there is a business case if you got the right, you know, folks interested in, at the time in their business where they want to try this out.
Alex Lawrence (21:24) Yeah. And I agree 100 percent on that. As I said, I think the primary care associations and stuff like that are in my brain would be like the most similar on there. And a lot of like the headwinds that we run into with them is like the primary care association has say all these fqhc like federally qualified health centers and they’re all handling credentialing individual as one. But basically when we do get the official buy in, it’s like then the credentialing is handled at the overview level. So then all of these people are basically just getting everything solved from one source of truth versus, hey, like this health center is handling it very efficiently. But this other health center is battling attrition with their credentialing team. And so they’re losing steam. So it basically unifies all that. But with those, a lot of the struggle is like some of the health centers are like, okay, well, we’re not interested. And so it’s like getting the buy in across there to make the case all the way through. And I think some of the ways that we’ve solved with them is like surveys like, hey, if we were able to offer this like this is what the simplicity would be. This could be like your accelerated time to revenue. Like is this something you would be interested in?
Alex Lawrence (22:51) And if you had like if you had 50 to 100 people that were 100 percent interested, like the case would easily be there. Yeah. But obviously, without a like contract, those people, 50 of those 100 could also bail out. So I think that’s like the risk reward kind of setup in my opinion. Yeah. But yeah, let me ask around. I don’t know worst case scenario. I will definitely send you some people that are like self service and could kind of go from there. But I am more than happy with. I’m in your bucket where I feel like if there’s a deal to be made, like there’s a deal to be made and if it’s not, then it, we party as friends and stuff. But.
Anna O’brien (23:34) Yeah, no, totally. Yeah, I know. And it’s also like, I know when I’m like Google searching and I’m coming across like the top tier like I’m like they probably are way too advanced for us but it’s a good place to start if and just check, my knowledge on it. So, yeah, that’s great. I appreciate it.
Alex Lawrence (23:53) Yeah. And I think like the biggest like take home. I mean, we, as I said, we’ve kind of moved to that enterprise level just because the automations cut so much like time, That you’re almost sitting there being like, well, we’re paying for all of this, but it sped it up like even too quick for us to move for like, but you don’t need to speed up essentially 10 people. But like if you’re trying to get 50 people in the door in billing for you, there’s 100 percent like, but with these people just trying to get enrolled with payers, and the other thing that I will say too is like we’re not really doing like your contract negotiation and stuff like that.
Alex Lawrence (24:32) So like when people are thinking of credentialing that way like that, is that’s not really our form of credentialing, like we’re doing the payer enrollment and like the credentialing as far as like verifying demographics like we’re not, we’re.
Anna O’brien (24:46) not, yeah. I think we need that part like someone who’s able to have some negotiating power and like I’m imagining like people going through a little bit of a cohort. So, but yeah, it’s a, it’s definitely like the time frame, they have more time on their hands and the fact that like this isn’t we’re not like a private equity funded company that’s like my, gosh we got to get everybody making money for us immediately. Like these are independent small businesses that like they have the patience to let it work. So that could, you know, we should probably rely on that because it’ll help bring the price down too if, you know, we don’t need that speed as much, but.
Alex Lawrence (25:19) Yeah. Let me, let me, I’ll look around, yeah, and ask a couple people on like their thoughts and stuff. I will also send you just like a little one pager explains kind of all about medallion as well.
Anna O’brien (25:34) Yeah, you’re.
Alex Lawrence (25:35) welcome to kind of forward that along to people and be like, hey, like would this be of interest kind of scenarios. But yeah, I will definitely is the email just on here best.
Anna O’brien (25:47) Vera, Anna, theravera, okay, perfect.
Alex Lawrence (25:50) Yeah. Let me, let me, I’ll send that to you immediately. Let me ask around kind of see what general consensus is. I don’t think it’s going to be too.
Anna O’brien (26:05) Yeah, I’m getting it. I’m not getting my hoots up, don’t worry mark. I do appreciate the time you spent like walking through this with me and helping me understand the roadblocks because that will help me in my journey. And if you know anyone, you know, who you or you’ve heard of, who’s doing good work, who may like be like more on the small business or like value this kind of like mission type thing, you know, we’d love to just connect. Yeah.
Alex Lawrence (26:31) Absolutely. Yeah, no, I will send off just kind of like what my initial feedback that I get from people are I’m kind of in that bucket where I don’t know, where the, I feel like there’s always an opportunity on stuff. I just don’t know if the timing would make the most sense at this.
Anna O’brien (26:50) Point in time. Yeah, it’s funny. I had talked to someone who did like more of the billing side of things and they had given me a quote and they were able to do all this. But she, like I emailed her back because it was October, I was not ready to buy it then. And like, no, she’s like out of business, I guess like I’m like, ooh, okay. I can’t contact her anymore. So I’m like starting from scratch. I don’t know what that means but, yeah. So, so I know like there’s something out there but I just got to figure out how to.
Alex Lawrence (27:16) Yeah. And, and, the billing and RCM companies are kind of another one of those where it’s like, we have partnered with like RCM companies to, and they basically have enough members that need credentialing. And so, the RCM company essentially sells credentialing to their members and it’s powered by medallion. But it’s one of those scenarios where it’s like, they know they have enough in the pipeline that it’ll make sense for them to make the initial investment. And that would, and that would be kind of my like advice for you. It’s like say, if you get enough buy in and there’s if you had even a third out of a 500 that are like, yeah, I don’t want to deal with credentialing myself. Like if we could handle this, I think that’s where the use case completely changes forward and that’s where I personally think you would find the most value just because like you would essentially be making an upfront fee and you’d be trying to hold these people accountable to like handle credentialing through you to simplify their life. Okay?
Anna O’brien (28:23) That makes sense. Okay. So even maybe if this doesn’t work, I should be looking at some local like billing people or CM people to see if they have relationships, yeah.
Alex Lawrence (28:29) I would say look at billing and stuff especially if you are looking for like rate negotiations and things there that’s kind of where I would probably start and find the efficiencies there.
Anna O’brien (28:40) Okay. Awesome. All right. Well, thanks so much, Alex. And I hope you have a good week. You as well. I will wait to hear from you.
Alex Lawrence (28:47) Awesome. Take care, Anna. Bye.
Anna O’brien (28:48) You too. Bye.