Sentara / Medallion - Demo

Transcript

Kyle Bettencourt (00:00) hey, good morning, Casey.

Casey Simpkins (00:02) Hey, good morning. How are you today?

Garrison Goodman (00:05) Doing good.

Garrison Goodman (00:10) Still shocked from that uconn and duke game. That was crazy.

Kyle Bettencourt (00:19) I missed that finish. I couldn’t believe it.

Garrison Goodman (00:22) I happened to watch the whole game, like, I wasn’t like, I didn’t see it out. Yeah. And, and hey, Kristen… we were just talking about the March madness, crazy ending to the uconn and duke game yesterday, where I happened to watch the game. I’m not a huge fan, but it was still a crazy end of game. I know I.

Kristen Jacks (00:45) Had uconn in my final four, so I was happy.

Garrison Goodman (00:47) Oh, wow. There you go. Oh, nice.

Kyle Bettencourt (00:52) Yeah, it’s always nice when you just pick a random game, and then you realize, you just sit in on an instant classic out.

Garrison Goodman (00:58) Of nowhere. Yeah. Oh, sure. Did I?

Kyle Bettencourt (01:00) Am not an expert. I,

Kristen Jacks (01:01) am not an expert at all. It was total, just guessing game, putting uconn in there, but it worked in my favor. So, I’m gonna take it.

Kyle Bettencourt (01:10) That’s a great. That’s a great win there, close the weekend out. Yeah.

Kristen Jacks (01:13) But it was crazy. It was a crazy game. I don’t know how duke lost a 19 point lead, but.

Garrison Goodman (01:18) Unreal. Yeah, I happened to watch with my in laws and my wife and neither of us are college basketball fans, although my father in law went to villanova and they were winning until the last second of the game, the whole game.

Kyle Bettencourt (01:34) Yeah, I didn’t realize it was that bad but.

Garrison Goodman (01:37) Oh, yeah, it was. They, I don’t think uconn ever had a lead until the last second of the game.

Kyle Bettencourt (01:41) Jeez. Yeah. Hey, Doris.

DORIS G PRINCE (01:46) Good morning. How are you guys? Yeah.

Kyle Bettencourt (01:49) Just talking March madness. So, don’t mind us over here. It’s.

DORIS G PRINCE (01:54) exciting.

Kyle Bettencourt (01:55) Yep. Are we waiting for anyone else from the sentara team?

DORIS G PRINCE (02:00) Did Nicole get invited? I’m gonna make sure she’s on there.

Kyle Bettencourt (02:03) I think she did.

Garrison Goodman (02:05) No, I don’t think I’ve seen your dog before. What kind of dog is that?

Noah Laack-Veeder (02:09) Oh, you can see her? Yeah, she’s.

DORIS G PRINCE (02:12) yeah, she’s on there. She’s on there. Okay. She’s like,

Noah Laack-Veeder (02:14) a, I call her the brown fox dog. She’s like shepherd chocolate lab, lots of other things, but she’s just like a brown fox. She’s cute.

Garrison Goodman (02:24) Super cool. You’ll have to send me a pic, big dog Guy here. Does she run with you?

Noah Laack-Veeder (02:32) She tries, she’s not very good at it, anybody else have pets on the call, Doris, Kristen, Casey, you all dog people or?

Casey Simpkins (02:41) Yeah. I’ve got two dachshunds that are sitting under my desk right now?

Noah Laack-Veeder (02:44) There we go. That’s cute. Nice. I,

DORIS G PRINCE (02:47) have a dachshund and a pomeranian, but a pomeranian that I think he was crossed with something else because he’s the biggest pomeranian I’ve ever seen.

Garrison Goodman (02:55) But,

DORIS G PRINCE (02:55) he’s also 18, almost 18 years old. So, he’s not 18. I’m sorry, 16 and a half years old, so, almost 17, but anyway, he’s very senile. So, I have to be careful because all of a sudden, I’ll look and he’s like on top of me or he’s there. And then he’s just like scratching at the couch, but it really means he’s scratching at the door to go out. So, I mean, it’s.

Garrison Goodman (03:17) like he’s.

Noah Laack-Veeder (03:19) like 120 in dog years.

Garrison Goodman (03:20) That is a legend.

DORIS G PRINCE (03:23) Absolute legend. My husband keeps saying, I’m like stop feeding him. He’s like he can have anything he wants. He’s at the end of life, whatever he wants. He’s got it. He’s like, I don’t care.

Noah Laack-Veeder (03:32) Whatever it is. It’s working whatever diet.

Kyle Bettencourt (03:35) It is and.

DORIS G PRINCE (03:36) then we have a Dotson who’s here some of the time and he’s funny. He’s all over the place. I can’t imagine Casey. It’s like wants to be in your lap. I’m like you’re too big. You’re too long. My legs are too short, get on the floor. It’s like, okay… all the above. And then I know Nicole’s a big dog lover too. She’s got doggies.

Kyle Bettencourt (03:57) Oh, nice. Yeah.

Nicole Beauchamp (03:58) I have a few of those.

Noah Laack-Veeder (04:00) You have a few of those nice. I have a,

DORIS G PRINCE (04:02) few.

Garrison Goodman (04:03) do you have dotsons? Too?

Nicole Beauchamp (04:06) Oh, no, I have… a pit, a Chihuahua and a shih, tzu.

Kyle Bettencourt (04:13) That’s a fun group.

Nicole Beauchamp (04:14) Oh, wow. Oh, yeah.

Kyle Bettencourt (04:18) Yeah. I have two goldens that think they’re the size of dotsons but one of them likes to lay down behind my office chair. And then I’ll just back up throughout the day and then just roll over her. And then she’ll scream that, I’m you know, I’m doing something wrong. It’s like you couldn’t pick a worse place to actually just, you know, to lay down here. She just loves you. You’re right next to me. Yeah.

Casey Simpkins (04:39) At the start of the pandemic, my wife used to joke, we had a really clingy Dotson and my wife used to joke that I would be on these calls and I’d have like the baby Bjorn with the Dotson.

Garrison Goodman (04:50) I know.

Noah Laack-Veeder (04:54) It’s funny because I mean, I use the baby Bjorn all the time with my seven month old, so, I can visualize that.

Casey Simpkins (05:03) So you’re going for it?

Noah Laack-Veeder (05:05) Yeah, that’s so cute.

Kyle Bettencourt (05:07) That’s great. We could talk about.

Noah Laack-Veeder (05:08) docs all day, but we could.

Garrison Goodman (05:09) Also don’t get me started. Yeah, don’t get me started.

Kyle Bettencourt (05:12) Definitely. So I’ll just kind of start with a quick recap of Friday’s call. Yeah, I think kind of the obvious focus for today is to really dive in depth on the demo and make sure that you guys get all of the, you know, information that you need from the medallion side to, you know, see if this will be the right fit, for sentara here.

Kyle Bettencourt (05:30) And so we’re really excited to show you guys. Yeah, I think kind of like our key takeaway after Friday, is that, you know, relating to sort of the big problem at hand for sentara, is that just there’s a lot of manual challenges with the existing credentialing enrollment function ultimately that’s having an impact, to patient access. And I think, in a perfect world and feel free to correct me if I’m wrong here. But you guys are looking for a centralized credentialing system that can span across all the different sentara enterprises, ideal solution would have organization wide visibility, you know, full automation to all of your administrative workflows and then be able to scale with your guys’ heavy growth projections. So I guess just quickly pausing, does that sound in line as far as what you guys are looking for?

DORIS G PRINCE (06:17) I would say, yes at this point in time, yes.

Garrison Goodman (06:21) Yeah. I think we were, our intention is to spend most of the time in the demo today. We just want to make sure. Is there anything else here, that you all want to see that, we haven’t listed?

DORIS G PRINCE (06:32) Yeah. I know, you know, my primary focus has been more around the enrollment, the payer side of it because again, we’re going to have to again if this is our system of choice or if this is the way we’re going, then we’re going to see a whole much bigger decision. But again, at this point, I really need to see it and understand it and see the functionality that you all have and what we can leverage, you know, to do better than what we’re doing today with all the manual pieces that we’ve got. So we appreciate it.

Kyle Bettencourt (06:58) Perfect. Yeah. And this is kind of the high level schedule that we have planned for today. So… yeah, I guess I’ll kind of let you jump in and maybe kind of walk through how you want to kick things off and then you can go ahead and take over. Yeah.

Noah Laack-Veeder (07:13) And if we need to, I mean we have two hours. So first of all two hour meeting, it’s a long one. So if you need a break, let us know, right? I can go for two hours straight. I can go for eight hours straight in the dallying, but don’t expect you all to. So just let me know if we need to take a quick break. And then after kind of each phase here, like we’ll kind of go back to the demo schedule, talk about what we might want to see next. But we also have time if there’s other topics to cover but we have plenty of time and want to make sure we get into it.

Noah Laack-Veeder (07:41) But if we kind of more or less push the conversation or the topic just know it’s because they want to show you the rest of everything and we’ll make sure that Kyle and garrison are just taking note of anything that we need to come back to. So, and.

Garrison Goodman (07:54) Also just to add if there’s any questions you have on something that maybe might go past, feel free to put them in the chat. Kyle and I will take notes and make sure we get back to anything.

Noah Laack-Veeder (08:07) But yeah, I’m really excited here. I talked to, I did a lot of work to get because usually there’s a lot of things that usually we don’t demo right away.

Noah Laack-Veeder (08:16) And I really worked with our product organization to get you just real views into all of the different automations that are happening. So really happy to show you all those things. So with all that being said, let’s just make sure you can see my screen. So one sec here, just hiding any pictures of my dog because I don’t want us to go back to the dog discussion. Okay. Can you see payr’s on your screen? Excellent. I’m seeing a nod from you, Casey. All right. So I want to start with what payr enrollment looks like with medallion. And I really want to highlight a couple things one, how easy it is to submit a new payr application, how we automate that QA process, making sure that nothing’s going to get flagged and rejected from the payr’s how we automate this follow up and give you real time status tracking. And then also just want to highlight how we can report on this and give you visibility into the different statuses here. So with medallion and I think this might be a little bit similar to your credstream process, but ultimately, you need to do something, right? You need to get a provider enrolled with a particular payr. So with medallion, what you need to do is just pretty much tell us what you need. So you’ll say we need an enrollment for a provider, you tell us who that provider is and what’s going to happen is we’re going to automatically surface all of the groups that this person’s linked to. Let’s just do community health center. For right now, you tell us which states you want to be enrolling them in. And one thing I just want to highlight right away is that if they’re missing a license in a state, we’re preventing you from making a mistake there. So there are some error checking happening up front where you’re not going to be able to make a mistake and submit an enrollment that’s going to get rejected. If we do Arizona, you can also then see that we’re automatically bringing in all of the payers that are associated with this group contract. So you might have 10 15 associated with that 10 already. You can enroll all of them at once just by clicking this checkbox here. And then you have the ability to check the different lines of businesses for all of these different payers that I’ve selected. So if I want to do select all what this does here is just says, look, I just want to make sure that I’m capturing everything as part of this enrollment request. Click next and what you don’t need to do now, just making sure you know this, you’re not going to have to get your stack of 10 papers or your 10 portal logins to start populating these enrollments. You just tell us which if you want to use the same practice locations and if you want to. And this is what most customers do they want to make sure they have coverage. So they’ll associate with these providers at all of their associated locations. You click next. We can also talk about adding this to their payer directory and also talk about that desired effective date. Sometimes it’s based on application submission date if we want to backdate it. But we can also talk about provider start date at your organization based on which relationship or agreement you have with that payer. You click next, any additional notes you click submit. And then what’s going to happen is medallion is going to take all the information we have on these providers and we’re going to start automatically submitting all of these applications and showing you what this looks like. I have an example of blue cross blue shield. It’s going to go pretty fast because our robo crawlers go really fast here. And what you’re seeing here is us pre populating and doing the application automatically. So there’s not a human doing this. This is actually AI doing this in automation. So all the information that we have within medallion is going to be automatically leveraged to perform and complete these applications. So I don’t want to make you dizzy here. But the big thing here is that we’re automatically putting all that information in there. So there’s no errors with oops. Their name is Casey. I missed the y. So it’s case none of those things will happen because we’re populating this information automatically. And the last thing I want to highlight before we kind of jump in and talk about this in more detail is that there are a lot of things that we want to check because if I miss one thing, then I’ll get rejected. I’m not going to show you all of like the hundreds of checks that we’re doing. But just to highlight here, what you’re seeing is if you need to enroll with 10 different payers, it’s a large effort to one remember all of the requirements and then double check all those requirements and then act on all the requirements before you get a rejection. So if you’re trying to stay, on top of this and prevent resubmissions, if you don’t have this automation, you’re going to have manual work to do so with medallion. We will do all of this automatically. So if you tell us you want to be with 10 payers, we automatically check all those requirements. And if something pops up that we can’t automate, for example, we can’t tell you what’s the correct data here in enpes, but you can tell us we’ll tell you, hey, look, we looked in enpes, and Michelle doesn’t seem to be Donna. Did she have a name change? Is this something that we want to fix? And so ultimately, what we’re doing here is surfacing all of these things that could go wrong. And so summarizing this all, we’ll check these applications. If there’s not any errors or anything missing, those things go out the door instantaneously. If something does have an issue and we can’t automate it, we will alert your team and then you can see the task in this task piece here. So on average, we are probably automating around 80 to 90 percent of the work just through these checks alone to make sure everything’s good. Anything that’s falling through the cracks. You don’t need to track them manually. We’ll auto, create a list for you. So those are the things that still need to be acted on. So I know that’s a lot of stuff right there. Just want to pause when we talked about kind of the manual nature of this with lots of applications coming through. I just want to see how this compares to kind of your ideal solution with payer enrollment. So.

DORIS G PRINCE (14:37) With this, I assume like any software solution, we would have already gone through data conversion, put all the information in there and all those type of things. So if it was a new provider, I assume we’d have to build or add or do something with that clinician so that you could then pull all this information in, correct?

Noah Laack-Veeder (14:56) Yeah. And we’ll come back to that. But that E wallet piece that you have, if it’s someone brand new… there’s going to be a data ingestion piece, yes.

DORIS G PRINCE (15:08) Okay. And then again, ever, how that provider is linked or synced, you know, whichever way you want to call it, you know, we have 10 different tax ids and that type of stuff. So it would pull, you have the ability to be able to. I don’t want to say dummy proof it. But in other words, if we’re doing this only for SMG versus rockingham or Martha jefferson, you can customize it and build it accordingly. Okay? Because each market has a little bit of different flavor of payers, it probably drives Casey crazy. It drives me crazy because I can’t remember what’s where, and what market and then take out our cheat sheet and look at it. But again, same thing. Okay. All right. Thank you.

Noah Laack-Veeder (15:45) Yeah. And so what you’re seeing here, Doris, and Chris and Nicole might be similar like this when we go through implementation, which we can talk about for an organization like yours usually around like an eight week implementation Ish. And ultimately, what this means is we get your current data into our system. Mostly we get this cheat sheet loaded in. So let’s say that one tax id you have, you know, that they are enrolled with these six payers, we dummy proof it. Where, when I showed you that kind of first piece here, when I requested that enrollment… kind of the dummy proofing is I would only show the ones that they’re associated with. And then also I’d only show the payers that are part of that. And if I have ones that are already in progress, there’s no need to submit that again. But you just click this button. And now I’m already submitting to all the payers that are associated with that.

Kristen Jacks (16:45) Hey, I have a couple of quick questions. I’m sorry. So it’s staying on that same screen, same line of thought. If we have more than one medical group that we are enrolling at that time, can you select more than one group in that little field box that said group, you know, like, can you click more than one?

Noah Laack-Veeder (17:04) Yeah. Usually organizations, when they’re doing it, they’ll do one group at a time. However what I want to talk about is like depending on the scale of the organization, there’s a little bit different ways that we do this. So let me put it this way if, during, if further conversations you say, look, I just want me, I just want to tell you that I want to enroll Naomi and you guys just enroll them for all of our groups and all of our practice locations. We can do that in bulk. It’s just not something I can demo to you, but the idea would be like, Kristen you go, look, I’m going to have 10 payers or 10 providers coming in? They’re going to be part of these two groups. Can you guys just do all those in bulk? You can use our request money to do one tin at a time, or you can reach out to your dedicated account manager who can do these things on your behalf in bulk, right? So there’s multiple options for requesting. But most organizations if they’re using our request module, they like to do it one at a time. But again, if you’re doing it one at a time, we’re talking like, I don’t know. I’d love to hear kind of how long that would take the organization to get all that information ready. It’s like I’d say about two minutes per group to get this module completed for all. For like total between those groups. It’s just like three clicks for each.

Kristen Jacks (18:25) Okay. And you had mentioned and I saw in the really fast paced piece, things were getting saved and whatnot, is that being saved? Where we could see it in this portal? Or is it being, or is the AI tool saving it and doing things and then push us to us later. How does that work? Yeah.

Noah Laack-Veeder (18:42) That’s a really good question just so I’m tracking you’re saying like, hey, we’re doing things in these portals. Do we have audit history from what is going on there? Is that the question?

Kristen Jacks (18:50) Exactly, like where are these all this stuff that AI is doing? Can we see it save, pull it later? If maybe questions come up, something gets denied on the payer side, like where is all that stuff being housed? Is it within our tool that we can save? Yeah, yeah.

Noah Laack-Veeder (19:04) Yeah, absolutely. So you’ll have full audit history here typically. And again, this is a bold claim but like just kind of hear me out because we’re addressing so many things up front. We are reducing a lot of the payer follow ups that can happen. So let’s say we’re stressed we didn’t have time to check the 100 requirements. A lot of those payer follow ups are going to be, hey, we got a follow up on this piece, right? So if we check those up front and automate those, then those are removed. So really the follow ups that might come in, they’re something like I’m trying to think of an example one that came up lately is like there was a malpractice insurance that like they needed more information about, right? Or there’s like a sanction that came up from this provider, not something that we can automate, but that would be the one type of follow up that would go back to your team. But the one thing I just want to highlight as well is that any of these enrollment lines, if there is something blocking it, we’ll surface it for you. And we’ll also tell you what tasks are still outstanding for that individual. I’m going to see if this one actually pops up here because sometimes just demo environment. So some things will show something. But this person has a couple tasks. So, Naomi, she needs to get her fingerprinting done for Arizona medicaid. This hasn’t started yet. And then also like that’s one piece where we’re stuck because they need to do this. It’s a client task. The provider will get alerted to say, hey, look, you got to get this done. But as like the admin of this, you would be able to see the task as well. So saying like, hey, Naomi’s, got this task that’s stuck. Let me work with her to get this completed. Does that make sense? Yeah.

DORIS G PRINCE (20:49) And I think what worked, what she was trying to get to and I don’t want to speak for you, Kristen, but let’s say again I’ll pick one of my favorite payers, unitedhealthcare is famous for putting in the wrong effective date, the wrong taxonomy code, but we want to be able to make sure that we have a saved application so that we can go back and say, no, this is how it was submitted to you. Please fix your system. Does that make sense?

Noah Laack-Veeder (21:09) Yeah. And we’ll have those I’m going to see if I can pull if I can’t pull and.

DORIS G PRINCE (21:13) That’s fine. Yeah, I just want to make sure we ask the question, yeah, I.

Kristen Jacks (21:16) don’t want to see it in this demo just to make sure it’s because the other question I had is, and I don’t know if I misheard when it was going through the AI portion. I thought I heard you say it’ll pre populate everything and if everything looks good and everything is filled in, it’ll go out the door. But then later on you said about maybe a little bit higher gets auto populated that 10 percent that doesn’t does it stop for us to review it? So I just want to make sure I understood, oh, sure, is a human looking at it and putting their eyes on it before it actually goes out the door, or if everything’s populated and filled in, it automatically goes out the door. Yeah.

Noah Laack-Veeder (21:56) So, let me just, so let me kind of clarify the timeline a bit because there’s a lot that went through there. So we’re not going to submit anything that has gaps. So like if we go through the 20 payers and there’s things that we think would be rejecting that application, we’re not going to send it because all that’s going to do is delay it like that’s. It’s just going to, it’s just going to delay the timeline. So we wouldn’t submit anything that has gaps for a lot of our organizations, right? Like we have all that we need and what they prefer us to do is they trust that our experts will review the export of say this is good. We checked other requirements. We’ll have a medallion specialist and expert look at that and make sure everything is good. Then we’ll send it out to the payer automatically. So from your end, if everything’s there, it’s out the door immediately. If there’s no issues, if there are issues because we can’t like our approach right now is, you know, if we don’t know which payer this person’s going to be associated with, we don’t want to do the hundreds like the thousands of checks just because we’re only going to do the checks that are associated with that payer, we’ll surface those once we know which payers they’re going to be a part of. But again, if there’s no gaps, it’s out the door immediately. If there are gaps, we would summarize those with tasks. And that’s an area where there’s two options. And I kind of want to ask the team here. We can reach out to providers directly like medallion can, and we can reach out and try to get them to resolve some of these tasks. And we can do initial outreach. And then we can surface it to your team. In the cases where we couldn’t automate it. The other customers just say, look, we just want to work with our providers, right? We don’t need medallion reaching out? Is there an option that would be better for you all in terms of what would be the ideal situation? Like would you want medallion to reach out to these providers?

DORIS G PRINCE (23:52) I think that’s something we have to walk through or work through in the past? You know, when we outsourced it previously, we did the reach out.

Kristen Jacks (23:59) Yep. Well, and it’s more so because I feel like oftentimes you’ll have an applicant say who the heck is medallion? Why are they reaching?

Noah Laack-Veeder (24:06) Out to?

Kristen Jacks (24:06) Me, you know, honestly because we have that now with axuall and some other things. So if they see something that, you know, has our vendor on there. So we try to make it very clear it’s sentara up front, but we get that all the time of so and so is reaching out to me. Is this spam, this doesn’t look like sentara. So we’ve always in the past leaned towards medallion, us internally reaching out to the applicant because of that practitioner experience to be honest.

Noah Laack-Veeder (24:32) Yeah. And that totally makes sense. I think ultimately like one of the next steps here is we’re kind of looking at like here is the automation menu of medallion. And there’s just a couple decision points, right? Like do we want medallion to do some automated outreach to providers? Do you want? And it’s there’s gonna be a couple items that we can just decide as a group. But in terms of the requirements checking and a lot of these kind of we mentioned last time, these more or less repetitive mundane tasks, those are just gonna be automated through medallion like the QA, the submitting via portals. And the other thing too, I just wanna, I wanna talk through that I didn’t mention is some of the mundane things that are happening is like checking portals for statuses and things like that. So I just wanna show you another piece where we do automate and authenticate and get status directly from portals. So if you’re seeing here, this is Pecos. So we’re able to authenticate on behalf of users. We go through this. And then ultimately, what we’re gonna be able to do here is we’re gonna grab the status directly from the Pecos portal and then direct that into our platform. So we’ll log in, grab the status. And from your end, you don’t have to, you can go in here and look at it if you want to. But there’s really no need we’ll update the status automatically within medallion. So we do these checks usually on a daily basis across medicare medicaid commercial portals to update the status automatically. So last time I think we talked about visibility sometimes being a challenge and that challenge can lead to delays and things like that. With medallion, the status that you’re seeing here is real time and the source is the portal. So you’ll see what the status is at any time you go in the platform? Okay?

Kristen Jacks (26:27) So, basically, and what I’m seeing is anything that would hold up the process from the very start of enrollment, straight through standard follow up, straight through why we haven’t got an effective date yet. You guys are scrubbing it and then just putting it in front of our faces. If we have to have some sort of human intervention to fix update, look at that kind of thing. Okay? Yeah.

Noah Laack-Veeder (26:48) That’s a good way of thinking about it, but it’s worth highlighting. We are reducing the rate of resubmission and follow up by so much from a lot of these initial checks. So there is a happy path where really the only notification that you get is when status updates and then you go, this person’s par and effective. So just highlighting this, I.

Kristen Jacks (27:12) know.

Noah Laack-Veeder (27:12) This was something that I think from last time you mentioned is more of a manual piece. But with medallion, you have full visibility as to when folks were effective, when the revalidation date is going to be in and things like that. So you’re not going to have to reach out to payers to know when someone’s effective. Because we have all those automations. As soon as someone’s par, we will let you know as well as the provider via notification. And so Doris last time we talked about kind of a broader goal around patient access being more closer to those RCM type tools, this is where we’re able to immediately say, look, we’re not going to have to wait a week to know if someone’s par, if they’re par, we have it in our system and it’s updated… good. So just thinking about that piece in particular kind of the visibility and around that. Like if we did have these effective dates available instantly, what kind of changes would that lead to?

DORIS G PRINCE (28:21) I mean, it could help to get the claims out the door sooner instead of them sitting on a hold at it.

DORIS G PRINCE (28:26) You know what I’m saying? Waiting for us to release it. So again, to me, it’s cashflow would happen sooner than later. And then if we didn’t have delays again with enrollment and that not reducing loss and revenue. So in other words, if you’ve got a cleaner process, cleaner workflow, cleaner, everything and you’re getting the approvals back sooner and you’re getting it more closer to the start date or the date you requested, because again, some payers, you know, how they are, they may not give it to us the date of our application. They may not give it to us, the provider start date. They may give it to us, the date that their committee’s internally or they finished their process depends on the payer. So again, all of that would help expedite all those pieces.

Kristen Jacks (29:07) Ideally, we want the effective date before a practitioner receives the patient.

Kristen Jacks (29:11) So if we can get that enrollment date into our PM system before they even see patients, that’s the ultimate goal.

Noah Laack-Veeder (29:21) And.

Nicole Beauchamp (29:22) it would cut down on follow up because some of the websites, we have to manually go out to check for the effective dates or the approvals, some of them don’t just automatically come to us.

Kristen Jacks (29:34) So, for example, we have a payer right now where their system’s down their entire system as far as us checking status, uploading information is down. So we are manually emailing our rep, you know, going okay, where are we with this? What’s going on? I have a whole list of people who are not certified yet or this or that, you know. So it breaks those things break on the payer side. So that’s a lot of what that follow up. We would call it ends up being as far as manual intervention.

Noah Laack-Veeder (30:05) Yeah, I do want to comment on that. I have something to kind of just show you but like it’s something that’s you know, and this isn’t just like a cop out. It’s like hard to demo but there are phone calls and emails and there’s going to be like hundreds of types that can happen and kind of thinking about where AI is really most beneficial right now. I’m not sure how aware you are of like the agentic AI and kind of all these different things that are happening. But we like that, let’s say we can’t get a portal. What we can do is we actually use agentic phone calls to call your payers to get those status updates. So if you’re having to wait on hold and let’s say, you know, we talked about the attestations, you have 700 providers. You’ve got, let’s say you have to get 50 status updates today. And the only way you can do it is by calling medallion can do those phone calls for you. And so they’re doing the phone call. They’re waiting on hold for you. And it’s not a sequence of events. It’s we call the 50 payers. So when those systems are down, we can call the agents, but we can also send emails automatically and there’s an email inbox that you’ll have access to. So if you want to see kind of what’s happening, you can look at it. But generally speaking, what our customers will do is they’ll just look at the emails just directly in the platform. Now, I don’t have any good examples here, but you’ll see we track any email activity in this. So you can actually jump into it and see what the emails look like. Going back and forth. If there is something that comes out that does need your attention, we would alert you and put it in the task menu. So again, you can see the audit history. You can see the phone call. You can see the transcript. You can see the emails. But what you would typically do is just say, are there any tasks that alerted me that I need to jump into? Otherwise medallion is going to be handling those on your behalf. So thinking about that case where the portal is down and things like that and… kind of visibility being a challenge or collecting that status kind of being a function of, do we have the time to do this today? What is the impact of that? Is that like delaying enrollments today? Yeah, everything’s.

Kristen Jacks (32:20) on hold right now for that payer, because we can’t get confirmation that our practitioner is uploaded in their system and we’re delegated with that plan too. So there’s a two part piece. They have to get certified, and then the enrollment piece we’re delegated with. So we are submitting to them a roster once we do all the primary source verification. So it’s just backing up all of those rosters to get uploaded. It’s backing up the cert process and the work’s probably being done. They very well might already be uploaded in there. We just can’t get tangible confirmation that it’s done. And what we don’t want to have happen is release claims and then they end up denying. So then we’re right back in the boat. And then Doris’s Ar, folks are, you know, pulling out their hair, trying to figure out why are things denying? And then guess what we put everything back on hold. So, you know, it becomes a vicious cycle.

DORIS G PRINCE (33:10) Yeah. And that’s just one payer. But, yeah, one payer. Yeah, yeah.

Kristen Jacks (33:14) At the moment, one payer? Yeah.

Kyle Bettencourt (33:16) How often does that happen just out of curiosity? This is.

Kristen Jacks (33:20) A weird scenario. Yeah. I mean, this is not normal. I’m just trying to prove the point of the manual stuff that we’re doing at times to try to get stuff done that’s all and curious on how that would happen with all of this technology, you know, stuff still happens. So there still has to be something that we would have to put in place to make sure work’s getting done even when technology breaks?

Noah Laack-Veeder (33:46) That makes sense. So, no, I think, yeah, from.

Kyle Bettencourt (33:51) Like the payer enrollment aspect, anything else that you wanted to cover or any other questions that the sentara team had? I don’t.

DORIS G PRINCE (33:59) think so. So, you’re basically, when you’re going out to the payer to think you’re verifying that it’s the effective date, it’s not necessarily verifying… all the data is accurate, correct you’re not checking to make sure the taxonomy code was what you submitted, the addresses. If you submitted five addresses that you got five addresses linked back, is it looking to that? Or is it not looking to that when you get your effective dates? Oh.

Noah Laack-Veeder (34:25) Absolutely. So just so I’m hearing this correctly?

DORIS G PRINCE (34:29) The quality piece of it, is there any quality? Yeah, go ahead.

Noah Laack-Veeder (34:31) Yeah. So there is. So there is a quality piece. And I think the piece that I’ll say is, so when you’re looking at the existing enrollments when we talk about visibility challenges, like sometimes it’s really hard to get visibility into location by location, effective dates. So when you do choose, let’s say, you know, Chris, when we look back at that module, you’re like enroll with all the locations. We’ll also be tracking the status for all of those here as well. Okay?

DORIS G PRINCE (34:58) Yeah, because we only have a handful of payers that are site specific, but, you know, medicaid being one of them. So if we actually, you know, requested, you know, the provider being linked to five practice locations and we get the effective date, we have to make sure we check all five of those practice locations because if not, we’re going to release the claims. All of a sudden, three of them may start getting denials. Only two of the locations pay. Okay, good. Thank you. Yeah.

Noah Laack-Veeder (35:20) And I mean, Doris, that comes up a lot and that’s why we’ve invested in this piece because the location and I just love to hear and maybe Kristen, you can talk about this like with the volume that you all have, right? And how many practice locations do you have usually per provider that you’re trying to track per payer enrollment? Oh.

Kristen Jacks (35:43) Gosh that really depends on the specialty. Is.

Noah Laack-Veeder (35:47) it like 510 20?

Kristen Jacks (35:49) Easily. Yeah, some can have quite a few. I know a lot of our payers are trying to push to have no more than 10 attached to them, but yeah, I would say anywhere between a couple upwards of 10 is probably our norm.

Noah Laack-Veeder (36:03) Yeah. And based on what we talked about last time, I’m assuming that like to track all of that, are you having to like have, like, are you tracking the location specific, enroll like location specific status in credstream? And is that just a manual activity today? No?

Kristen Jacks (36:20) It’s tracked in credstream today. It’s a lot, but yes, it’s tracked in credstream per location, the provider is linked to every individual location. And then the team can easily see what the linkage is. And then they make updates, you know, for medicaid, for example, they will make updates to their workflow per location, so that.

DORIS G PRINCE (36:38) It’s documented. Yeah. So we’re manually. Yeah, we’re manually adding that today. No, it’s no, no technology. Yeah, no automation at all. It’s literally me George prince doing Edna cigna, united, humana, whatever my payers may be, and then either getting the approvals back into our box or us doing a follow up to the website or whatever it may be. And then manually going in, some of my payers may send a monthly roster approval. But no matter how it is it’s manual, I’m going in there for Doris prince, I’m going in there for Nicole. I’m going in there for garrison, I’m going there for each provider and putting those effective dates in.

Kristen Jacks (37:16) Yeah, by location. Yep, by location. So just.

Noah Laack-Veeder (37:20) kind of thinking about this, right? Imagine now, you don’t need to do that manual tracking, right? One, is it a big sigh of relief? And then two, what is that going to help us do if we have that off of our plate, right? So.

DORIS G PRINCE (37:34) That’s where we’re at. And that was our original conversation because again part of this is, you know, we are much bigger than what we originally planned to be. We are growing and tremendously. So this was the ask of me to go out to look for AI technology that could either replace and or complement the tools we already have. So that I don’t have to have a team of 44 this year and another team of 64 next year and 100 in a year or two from now, you know, or three from now, that was the ask, you know, what are these mundane repetitive things that AI could do? Well? And I’m like I want to say, I want to make sure I say do well because you don’t want to have all the nightmares behind, you know, make sure that it works, it’s doing very well. It’s doing the things it’s supposed to do. It’s dependable, it’s reliable and it’s working well, and it has a proven track record for that. So again, our goal is to one be more efficient, not have to continue to add a ton of staff to do stuff. And again, I would rather use someone’s brain to do the things that have edited out or need real work. You know what I’m saying and be the face to sentara versus being the heads down, trying to do all this manual stuff. So that was the biggest thing. I think I freaked everybody out in finance when I started doing my staffing when they told me we were going to grow by 40 percent and I said, well, just so, you know, before the end of the year, we’re going to need another 23 people and they’re like, so everybody just about had a heart attack.

DORIS G PRINCE (39:01) So again, it’s between the caqh maintenance and all this manual stuff. It’s a lot. It’s a lot. So that’s what we’re looking to see.

Noah Laack-Veeder (39:09) Yeah, and it may be premature, but from like the payor enrollment piece is what you’re seeing kind of consistent with what you’re looking for?

DORIS G PRINCE (39:19) Absolutely. Yeah. Okay.

Noah Laack-Veeder (39:22) So, that was the payor enrollment piece. I do want to move into some of the other pieces around like your delegated agreements and how we can help with that and kind of the roster exports. And then we’ll also talk about that analytics reporting as well as the caqh maintenance and pieces like that. So let’s jump into that. So when we talk about the delegated agreements, do you have like an ncqa committee that’s reviewing files regularly? We do.

Kristen Jacks (39:50) Have an internal credentials committee meets the third Tuesday of every month. So they approve, my team, puts together all of the final file and then they review and approve each month.

Noah Laack-Veeder (40:00) Great. So, Kristen, what part of the process is your favorite, the primary source verifications, the cred file creation, like what’s your favorite piece?

Kristen Jacks (40:11) Delegation is not my favorite at the moment in general even though it was blood sweat and tears to get them to where we are today. We don’t do the actual primary source verification. So we outsource that piece. Now. So we get a final packet back and then my team audits, it puts it together. And then I present it to committee. I would say what takes the longest in that process is obviously the auditing of each file, making sure we have every single piece that meets criteria not just for ncqa criteria but the individual payers criteria. That takes the longest as far as an individual person looking at it. And then obviously just review of our bulk submission rosters. Nicole has worked tirelessly with my delegated folks to get our rosters to where they are today in credstream. But each payer is for lack of a better word is a royal pain in the butt. So they require very specific things.

DORIS G PRINCE (41:07) On.

Kristen Jacks (41:08) their bulk submission spreadsheets that we are required to send to them every single month. So there’s a lot of manual intervention even with all the work that’s been done, it’s leaps and bounds better but still requires, you know, tweaks and updates and things because every payer is just a little bit different. So the biggest thorn I would say is probably our bulk submission process because our payers are just very specific on what they want.

Noah Laack-Veeder (41:32) Yeah. And you said you outsource the primary source applications are those being done by credstream today?

Kristen Jacks (41:38) I mean, I meant by outsource meeting, sentara’s, I apologize. My team’s not doing the primary source credstream’s doing that for us. Yeah, sorry.

Noah Laack-Veeder (41:47) Yep. So just to, so I just want to kind of walk through this process because ultimately, Doris, like I think one of the goals that I thought I heard last time too is like let’s try to do as many of these in the same system. So we are also an ncqa accredited cvo similar to credstream so we can do, and then we can just facilitate the credentialing process. So what this can look like is if we have like Naomi here, you’re going to see some of these failing because Naomi’s not real. So that’s good. But we’ll do the primary source verifications that are required from ncqa. So, mpi, oig, Sam, deathmaster ofac work history, all these education training, all the things that you’re probably having to do today. We can do those because they’re going to be ncqa checks. And then we can create the individual cred files. Now, I’m showing you if your organization likes PDFS, we can have these PDFS available for you. But other organizations that we work with, what they’ll do is they’ll actually have their committee, they can actually go into medallion and then look at the cred files themselves. Or if I’m thinking about your current workflow, Kristen, if you’re having to present these to the committee, you can present it from medallions. You can show, look here’s all the things that we checked everything is in this case, everything was clean and you can go through these different individual pieces here as well. But ultimately, what this does is the credentialing process that you’re having to do today, but it’s in the same platform as everything else. So in terms of timeline especially with our caqh integration, if we’ve got a provider with a caqh profile that’s up to date, we can get these cred files completed in one day. So all the primary source verifications are run and we’ll have that cred file available for your committee in one business day. Obviously, if there are gaps, those are some things that might delay this a little bit. But if you’re meeting like once a month, what you can imagine is your committee would have a list of providers that they can make those determinations and votes on all in a single platform. Once this is done, we do have those payer rosters. We have those payer rosters within our platform as well. So what you’re seeing here is one of our customers. They’re happy to let us show this family care center by the way they went from zero. Delegated agreements to around. I think the number is at nine garrison. And Kyle, we can kind of go through that K city again, but we regularly produce those different rosters across all their different payers. So you’re not having to manually create those. And we have, if these are the major payers, then we’re already probably sending rosters on their behalf as well. So just wanted to highlight this. If this is kind of the similar process to credstream the whole point here is that I think we’re at parity. I think the big piece would be, are we able to go faster and that’s I think based on our timelines, our average performance is around one business day to get these credit files completed?

Kristen Jacks (45:05) Can I ask a question around the one business day yeah?

Noah Laack-Veeder (45:08) How.

Kristen Jacks (45:09) are you getting educational facilities to respond to you so quickly? Especially if they’re not using the national student clearinghouse or something where we can confirm the education yeah. So.

Noah Laack-Veeder (45:18) That’s a good question. So, our default process is like you said, go through the clearinghouse, or we can see if we can use a proxy measure of education. Are you able to get education via proxy today or?

Kristen Jacks (45:31) What do you mean by via proxy? Like?

Noah Laack-Veeder (45:33) If you go into caqh, if they have their education history in there, we can usually use that as some proxy to say that we verify the education. Is that something that you’re able to do? I don’t.

Kristen Jacks (45:44) know if ncqa allows that well, it’s not a primary source, then you’re getting it secondhand essentially via caqh, not primary source from national student clearinghouse, or the facility itself. So ncqa would allow that.

Noah Laack-Veeder (45:58) Yeah. I mean, I think we’d have to go through like specifically what the requirements are for that facility, but we do our… because we pass our ncqa audit. We do this for many of our ncqa customers. Yeah, we go through the clearinghouse or proxy first if there is. So let’s just go through the case that like we can’t use a proxy or we can’t do the clearinghouse. This is a situation where a lot of organizations spend a lot of time trying to get that, reach out to the educational sources to do that. So medallion can either use individuals on our staff or we can use the same AI technology to reach out to the education to get their verification. So ultimately, like there are going to be a couple of cases where like they’re just taking a longer time to reply, but where organizations struggle is then they have to continually call them or reach out to them and try to get that. So organizations will like just offload that to medallion and use our agentic AI so that we’re doing the education verifications on your behalf. And then we’ll store all the record within here. So like let’s say I did the education training, like if it wasn’t if it was sourced by automation or sourced by a person calling or whatever it might be, you’ll have visibility into, how we did that. So you’ll have information around what the primary source was, as well as like if we actually called someone, we could have audit record about that was so ultimately like we have to have proof of that for ncqa and we’ll just like we have various means. But in the case where we can’t use those two, that’s a great instance for one of our agents calling the educational institution. So you don’t have to wait on hold or keep sending emails to get that. Yeah.

Kristen Jacks (47:45) No, that’s wonderful. Again, I’m not asking to put you in the hot seat. I am asking because this is what I’m experiencing now and with any cvo we have used, whether that’s our old, you know, group that we use currently with credstream even with our hospital cvos that seems to be especially during new grad season, some of these, you know, educational facilities are just not, they’re just not being responsive, you know, you can’t get to them because.

Noah Laack-Veeder (48:08) they’re getting inundated and you don’t want to wait on hold, right? Yeah.

Kristen Jacks (48:11) You’re getting inundated with it. So I’m just curious when I hear one day, I mean, again, I’ve heard all sorts of, you know, numbers in the past and other clients, other people try other vendors giving us the sales pitch. And I’m saying that saying you’re giving me a sales pitch, but.

Noah Laack-Veeder (48:25) I’m.

Kristen Jacks (48:25) just throwing it out there as fact here. We’ve heard all sorts of we can turn things around in seconds. And personally, I’ve not seen that. So that’s why I always wanted to ask the one day if you guys can make that happen especially on the education piece, especially if we could do something by proxy and it works for our payers, then hallelujah, I will do a dance here like I’d be so excited. So, you know, I just don’t want to, I just want to make sure I’m understanding again, I’ve heard it all recently and, you know, I want the reality good.

Garrison Goodman (48:57) Call out like, we, when we talk at high level, it’s about our averages across the us. And then when we think about like, all right, hey, this sounds right. We want to move forward. What we’ll do is we’ll map out like, your current standard operating procedures and then map that out to like what you have to do, current state and what it would look, future state and how much speed we could actually gain on a per step basis by how you’re operating today. I guess there’s a lot of nuance, for each of our customers?

Noah Laack-Veeder (49:24) Sure. And.

Kristen Jacks (49:25) Can I ask too outside of the verification piece? When you create these, we call them monthly bulk submissions, right? Those rosters, those spreadsheets that go out to the payor each month after committee, are you guys creating the roster and then automatically sending it out so.

Noah Laack-Veeder (49:40) We, we have to make sure that you send it to ncqa standards? So we will send you the roster for you to review and send?

Kristen Jacks (49:47) Yeah. Okay. Perfect.

Garrison Goodman (49:49) And one thing I want to touch on retouch on, Noah mentioned it like a big value add for a lot of our customers is like, yes, we can work with you with your current delegation agreements. But as you’re expanding going into new states, taking on new payers as you take on or want to pursue new delegation as well because we’re ncqa certified, we can really help in that process as well. You still have to have the volume that would necessitate delegation. But because of the relationships we have, you tell them that you’re using medallion, that process becomes very fast and very easy. So.

Kristen Jacks (50:21) You would essentially work with us as we go through our pre assessment. You know, as you get, a new delegated agreement, you have to go through a pre audit, pre assessment, you have to show all the documentation, full rosters, all that kind of thing. So then we would essentially partner with you on that.

Noah Laack-Veeder (50:36) Yeah, we just need to, you know, like the standard things policies procedures, all the things you’re going to need for a pre delegation audit. And then the pieces where it’s like, hey, send us the sample of the 10 files. Like have the proof that you’re running this? The good news is you’ve already been running this process. So that kind of proof point is an easier piece for you new organizations. It’s like we don’t have any yet. Well, it’s like, yeah, you have to do this for about a.

Kristen Jacks (50:59) Year. You have to create them. Yeah. No, we have all of our processes in place. My last question around delegation. I apologize for the 1,000,000 questions, no.

Noah Laack-Veeder (51:06) Don’t apologize. Great. Yeah, we.

Kristen Jacks (51:08) have threshold that we meet for our files? So my question is, I know you had mentioned you can pull up a completed file right here in medallion, present it to committee. We have the majority of our files meet threshold. So we essentially just send a very simple spreadsheet to my medical director that says, hey per week, these are all the clean files that meet threshold. And she just kind of gives a yep approved move on. And then we add it to our rosters per month. So I’m only really presenting our issue files is what we call them, the ones that don’t meet threshold. So, would you be able, does medallion build that threshold in a system? So you’ll automatically know meets it doesn’t meet it.

Noah Laack-Veeder (51:53) Yes. So let me show you this. So we have kind of, so this would be kind of your threshold and maybe we’re aligning on what threshold means and clean, like how we’d usually define clean is that we ran all the primary source verifications and there was no issues and we just say, okay, that’s clean. We’re able to distinguish clean versus like we just usually it’s clean issues. If you have a different process for clean, where it’s more or less an auto approval process, we can have those separate than the ones that have issues. So if it’s like a, so your question, I think what I’m hearing is like, hey, can we just have a kind of more streamlined process for these clean files? So we can just administer the committee review faster? Yes. Typically, the, what we want to see the committee review in your workflow already seems more advanced than a lot of the organizations we work with, a lot of organizations. They just say, look, we don’t need, we just have one stack and we’re reviewing clean and, those that have issues in the same meeting. We really only want like the meeting time to be on those ones with issues, not the ones that are clean. Oh, yeah.

Kristen Jacks (52:59) No, I mean we process too many files per month to sit there and have my committee look at every single file that’s crazy. Yeah, not if they meet the standard which I can share, you know, thresholds very easily, but I was just curious, I know that’s what that’s real. I mean we are putting together a file regardless for audit purpose. We are saving that clean file because on annual audit for any one of our delegations, they’re going to put us pull a sample of files. So I need to show everything, but we’re really doing the extra work when it’s an issue malpractices come up. If there’s a sanction, something, you know, that requires the committee to be like, let’s discuss this a little bit further before we say yay or nay, basically.

Noah Laack-Veeder (53:40) Yeah, 100 percent. Yeah. So, you know, we, we’ve we work with those types of processes today. So I don’t really see an issue there. Ultimately. I think the, this… is, you know, from what we’ve talked about at parity with this piece, I think the one idea that I would say is a value out of medallion is we do have that caqh integration up front so we can pre populate, and when it’s ncqa credit, if there’s caqh profiles up to date, we pretty much have everything that we need to start kicking off the process. So this can really streamline it. And ultimately, what you can do is you can just like when you invite a provider, we can do, we can pretty much… initiate ncqa credentialing as soon as you invite them. So if that’s the process that you want to do, it’s kind of like if I kind of zoom back to the beginning, we invited providers, you say, get them through the ncqa piece. We’re also going to do payer enrollments at the same time. This machine is kind of doing all 10 things at once, right? Versus having to have different workflows for I’m sorry, credentialing, payer enrollment, et cetera. It’s all.

Kristen Jacks (54:50) Happening. No, it makes sense. I mean that’s why we utilize the caqh app today because it ties so closely to what ncqa requires and it’s our data source that we use for all of our delegated payers for that exact reason because payers are comfortable with it. So when we say we’re using the caqh app, it’s just a great done that way they’re not having to approve a special app that we’re using or anything like that. We can just say, hey, we’re using caqh and it’s you know, again from an audit standpoint, they’re just checking a box on their side, saying yep sentara is using the standard, which would be caqh. Yeah.

Noah Laack-Veeder (55:23) So that caqh app application like, so when you’re credentialing people, you can say like new providers, right? But if they’re existing providers, then it’s the same idea where like we’re pretty much initiating the caqh application as soon as they’re kind of identified for credentialing. So we’re going to be able to match that caqh app process that you have today.

Kristen Jacks (55:46) Okay. Yeah. The key there being that caqh is up to date before we pull it in to do all of these things with sentara information and.

Noah Laack-Veeder (55:55) If it’s not updated, then we’ll like we said, with the payr enrollment piece, we’ll highlight the things that need to be updated. Okay. Yep. Just.

Garrison Goodman (56:06) Real quick. Casey, you had sent your question in the chat here, just want to make sure that was answered. Thank you. Yeah, you’re good on Noah’s overview. Any other follow up questions on that?

Noah Laack-Veeder (56:22) No, that was good. Okay. Thanks. Awesome. So it sounded like, the… biggest time saving here would be around the roster piece. And so, Kristen, based on what you saw having medallion just have those rosters templatized and sent to you whenever they are due. Do you see how that would be saving you time?

Kristen Jacks (56:48) Yeah. I mean, I think so. I mean, it would definitely… that, that’s a big piece of what we manually look at and review. I mean, there would still be that manual effort, but if everything is clean and we’re just reviewing it, that would certainly save time as opposed to having to still touch and tweak and, you know, do certain things to the rosters and the rosters change regularly. So I’m assuming obviously, you guys are able to make those updates to those templates on a regular basis and payers change their mind quite a bit.

Noah Laack-Veeder (57:16) Yeah, absolutely. Yep. And then Doris, kind of earlier kind of this broader goal of also having that single platform like kind of having credentialing and the payer enrollment all on this kind of automated platform. Is that similar to what you were looking for?

DORIS G PRINCE (57:36) I would say, yes. I mean, again, we were definitely looking for AI technology either again to supplement and, or, you know, say and say, yes.

Noah Laack-Veeder (57:46) Yep. Okay. And Nicole, I just want to hear from you any thoughts or feedback so far? I think so. Okay. Maybe Kyle or garrison, could you just help me with the next topic here? I just want to make sure I’m covering it all.

Kyle Bettencourt (58:03) Yeah. We had a payer follow up automation, AI agents, and then really just kind of doing a recap of the caqh bi directional sync and provider onboarding. Yep. Okay.

Noah Laack-Veeder (58:17) So let’s go to the caqh piece. I talked to the agents thing. If that’s something that you do want to see. I just, my product team said that that’s something that we may want to go under NDA with that’s just if you all want to see that because it is like it is pretty new. So that’s just something I can talk to. But if you want to see it, that’s a, that’s the next step there. But I can show you the caqh piece. So I was able to work with my product team here to get you just a real video of how this is working today. So again, it’s going to be really fast. But Kristen and Nicole, what I kind of want you to start thinking of is like, okay, this is a lot faster than me having to do this and kind of like copying all this data in. So just showing you here, this is our robo, like our robo crawler going through and updating caqh pretty much instantaneously. So whether it’s an attestation or an update as part of the application, we are integrated with caqh. So anything that’s been updating, we will be pushing it to caqh again, like either it’s the initial application that we’re doing that or it’s the quarterly attestations, we’ll be facilitating that process automatically with medallion.

Nicole Beauchamp (59:34) If this is a provider that is with us and another company, this would only update our information… is.

Noah Laack-Veeder (59:44) That are you have, are you having to update both companies today for the individual or so?

Nicole Beauchamp (59:51) When they, sometimes when we do the reattestation, they have to attest to all of the locations and some of the locations are not ours. But in order to reattest, yes.

Kristen Jacks (60:04) Yeah. So everyone playing in the sandbox, right? And like everyone touches a caqh profile across the us, you know, for a provider.

Noah Laack-Veeder (60:15) So I didn’t want to hear make you guys hear me cough. I didn’t prevent it 100 percent. So today, when your providers are doing that, are you only doing the attestations for the stuff that you’re responsible for? I just want to, because last time I think we were talking about like that list of 700 Kristen that you’re having to do? How are you doing that today? Like are you only again doing the ones that you’re responsible for, or are you working the provider to get everything done in caqh? I mean.

Kristen Jacks (60:45) Ideally, we only want to touch our stuff, right? You know, it’s kind of like again the playing nice in the sandbox, we want to make sure that we are not messing with anybody else’s stuff in the system but want to get our file through for our stuff. We are finding as I think I mentioned it when we met last week, we have so many practitioners now that we are contracting with that are working in multiple organizations across the U. S. So Nicole’s right? We’ll have, you know, a certain state that’s primary for them at the moment that’s not Virginia, which is where we are primarily. So we’ll have to tweak it and change it and make Virginia primary so that we can get it through and attest it. And then they have to go back and change it. We don’t want to step on other organizations toes. But if it holds up our process and we can’t attest to their caqh account, then we have to work with the applicant and say, hey, do you mind if we do X y and Z? We try to be mindful, we don’t want to delete anything, change anything, do anything for somebody else, especially if sentara is not their primary employer… right? But it can be challenging at times because it causes us just to stop. So I can be like shoot, this is not really related to sentara, but it’s caqh holding it up. Yeah.

DORIS G PRINCE (61:57) And we don’t change the primary because again, if we’re not primary, we’re not changing that the primary stays the primary. So if primary happens to be key care and they’re in California, it stays primary. We update our stuff, but we will have to attest to the key care one or it won’t go through. So I assume that’s what you’re doing as well. You’re probably just attesting to everything. Yeah, I.

Noah Laack-Veeder (62:20) Can that’s something that I want to follow with my ops team around? I do know a lot but there are some things that I can just kind of ask my ops team about. We’ve definitely encountered this in the past. I just want to make sure I get you like our default workflow. And then we can kind of talk about how we want to do it. But ultimately like we can, I kind of think about like we can subset who we are doing updates for and we can kind of like think about how we do that. Let me just talk to my ops team to give you just our workflow in these types of cases. Does that sound fair?

Kristen Jacks (62:55) Yeah, no, that’s perfect. Thank you.

Nicole Beauchamp (62:56) And do you guys also update when the provider terms start? Are you removing information from caqh? I.

Noah Laack-Veeder (63:06) think that totally depends. Are you all doing that for your providers today? Like are you logging in on their behalf and then removing them from the organization? Because like you probably have like a caqh org profile and you’re probably removing that provider or how is that working today?

Nicole Beauchamp (63:24) Well, I know they’re logging into the provider caqh and updating it there. Okay? And I’m assuming.

Kristen Jacks (63:30) Yeah, if we’re notified of the term, we’ll do.

Nicole Beauchamp (63:33) That, yeah.

Noah Laack-Veeder (63:34) Yeah. Let me, how about this? I’ll as a follow up to this call, I’ll send you the questions that I heard from today around the caqh piece. And if there’s anything that I’m missing, please add it in there. And then I can just have, I can just route that to our internal teams and just give you like our different ways of doing that. Does that sound good? Yeah.

Kristen Jacks (63:58) And it’s terms, I would say across the board, I’m curious on how you guys handle terms across, you know, everything’s terming in caqh terming, with our direct enrollments, again, adding the terms to our bulk submissions on the bulk submission tab for delegated payers, and even for surrogacy, I saw you guys pull up CMS, pull up Pecos, you know? So I would imagine we would have to give you all surrogate, you know, access to our tins, but same thing, you know, when we term a practitioner, we term our surrogacy connection to that practitioner. So we can no longer work on their behalf. So I’m curious, you know, if, yeah, you guys would log in and do the same thing if you’re managing those enrollments.

Noah Laack-Veeder (64:37) Yeah, these are definitely like really good like how this works day to day like operational questions. So let me make sure and it’s normal. Like usually we’ll get through this phase where we go through the different technologies and kind of see how this automation works. But we have to like as garrison said, make sure this fits into what this new workflow is going to be. And obviously, you’re a large organization, there’s some complexity there. So we can just start enrolling more of our operational folks just to make sure we’re getting clear answers about how this is going to work in the future. Thank you. But from the technology perspective, we have a connection with caqh, there’s going to be nuances around like nuances around what is going to happen with that. And I think we can just work with our ops team to figure out how that’s handled differently. But it’s going to be done through this automation and the way that it needs to get done. Okay? So, yeah, I think we did cover the payr stuff. I know we had two hours for this but I definitely want to have a buffer for some other pieces but just kind of the general problem or opportunity that we’re looking for Doris was and others is let’s get a software that can do more than just one thing. It’s embracing latest technology around automations, AI, and things like that, which will help us with this large scale or this large growth that’s coming. We’re not going to have to expand the team like double in size to handle that. From what you’ve seen today. Do you feel like this is a step in the right direction where medallion could be helping with that? Or what other things do we think we need to see from a technology perspective to give you that confidence? Doris, you’re on mute? Sorry… I hit.

DORIS G PRINCE (66:23) The wrong thing. Yeah, I think it definitely checks all the boxes, you know, as far as, you know, doing the automation, doing those manual tasks that again AI technology can do. I definitely like the follow up and stuff like I shared the other day with our waystar vendor today. It does that for us with all of our Ar, follow up denials and all of those pieces as well. So again, I think it checks all those boxes.

Noah Laack-Veeder (66:48) Chris and Nicole is the folks that are kind of having to like run this day to day. Like how are you both feeling?

Nicole Beauchamp (66:54) Yeah, I really like it. Yeah.

Kristen Jacks (66:58) I mean, I agree that this, I’ll be completely honest. The caqh bi directional feed is something that I think Doris Nicole and I have wished for, asked for wanted for years.

DORIS G PRINCE (67:09) Knowing that, you know, just.

Kristen Jacks (67:11) Knowing the maintenance and the efforts it takes to manage caqh. So it’s really cool to say, I will say that and the.

Nicole Beauchamp (67:17) simplicity of only having to go to be able to do the payer enrollment request from the one website. So then now they’re not having to go to all of these different websites, different forms. Yeah.

Kristen Jacks (67:29) I agree that’s really cool to see that technology in one spot. 100 percent agree. I mean, that’s.

DORIS G PRINCE (67:36) been the whole thing with Healthstream for us the whole time. It’s like it was always utilized for a hospital. I’m not going to say it doesn’t work well for them. But as we got into the payer enrollment side of, it was like, holy moly. This is very manual. I felt like we literally are doing our excel spreadsheets that Kristen’s team was doing literally doing excel spreadsheets in an application, just literally just doing data entry. But on a screen now instead of an excel file on the screen, right? Yeah, one.

Garrison Goodman (68:09) Of the things that you had mentioned on the last call was just like, hey, we want better visibility too in regards to where things are at. And between, you know, sometimes you’re staffing folks where you’ve been told there’s an enrollment status, but it’s not updated in the system and you just don’t have that like parallel of data that’s happening. We’d like to show you, I think how we look at reporting and visualization, okay? And I think through that, if we could get a better sense of like, hey, how could that impact things, for you and Ron, when it comes to scheduling, staffing, forecasting, those type of things that would be helpful on our side?

DORIS G PRINCE (68:46) Yeah. Okay. And, and reporting is huge too, and I had that as a takeaway to talk about too, because one of the things that, you know, I’ll call us, I don’t know, I feel like we’re traffic controllers 99 percent of the time as well. And I know your other organizations probably feel the same way. So, we have practice operations, you know, operational leaders who are hiring all these clinicians to come in and work for sentara, and then from there, they want to know where are they at? What is the status, you know, how far along are they? And then now Vicki Charles, which is one of our great VPS in finance who just recently retired. She literally would beat them with a stick. No, not literally but make them think that she was going to, I was like hold.

Noah Laack-Veeder (69:33) on, let me go on mute for a second.

Garrison Goodman (69:36) Y’all, do things different in Virginia Beach? I.

DORIS G PRINCE (69:38) was just joking but when she spoke, people listened, I’ll just say it that way she managed our revenue cycle department for many years. We reported up to her so she understands the impacts and the financial pieces of it being our VP of finance. But anyway, one of the biggest things is she literally has gotten them to the point now that poor Kristen’s having to live this every week where recruitment is going. No, they’re not credentialed. They can’t start. So we got to change their start date. Now, we’ve become the bad Guy, you know? So that’s the other thing is we need to be able to, yeah, now, we got to be readily able to be able to say, okay, yes, Doris prince is scheduled to start on June one. Where’s she at in the process, you know, they want to know. Have you got 80 percent of the payers already enrolled? Have you got everything that you need to be able to get it started? So that she will be 100 percent enrolled by her June one start date, that type of thing. Because if not recruitment and talent acquisition. Now, saying to our team, we’re going to have to move this person’s date because they’re not going to be ready by June one. And we’re like credentialing doesn’t make that decision practice operations. Does you know? So again? Just trying to make sure that we have that because Kristen does meet with operational leaders at that level. So we may have a, you know, a leader who’s over our North Carolina practices. We have leaders over just our primary care, but only in the eastern market or the western market or northern market, whatever they call it today. It’s constant changing of reporting. But, you know, today we’re doing a lot of that manual pull. We have a list or a market or an area or practices that we know a leader is responsible for and having to pull out that information and send it to them so that they’ll know where their providers are at. My goal was to be able to teach people how to Fish and go Fish versus us constantly sending out updated reports and stuff, but have either, I don’t know something like a tableau or reporting tool or something where they could go in and pull the information themselves. But we just haven’t gotten there yet because it’s very clunky still within credentialstring. Yeah. Well.

Noah Laack-Veeder (71:53) I think we kind of touched this a little bit but I just want to kind of go through the other things that executives typically look at within medallion. So reporting I’d say is one of our strong suits at medallion… organizations are actually moving from legacy tools to this because they don’t necessarily want to invest in a tableau yet or they want something that can connect to a bi tool down the road. So, with medallion, we have what I’m going to show you in the platform, but we also have the API connections where if your organization does invest in more robust analytics, we can export, our data out.

DORIS G PRINCE (72:28) But from a.

Noah Laack-Veeder (72:29) dashboard perspective. I’m not sure Kristen, if you had to do anything like this, but executives typically are interested in the volumes that are happening. But also like when were people par with different organizations? So we can make sure we know from a scheduling standpoint, what we got to do. This will at least give you a high level of view as to how many people are getting credentialed each month and where people are in the process as well as the latest completed enrollments and then how long each step in the process is taking. So we have that full visibility around volumes and turnaround times for your providers. But in the spirit of teaching them how to Fish in that same kind of status check here, they can view, they can, you know, we can look for someone we can sort, we can do all kinds of things to get this information out to say, I need status by location, status by whatever it may be. And then, but from like a start date perspective, the most important data point that individuals are looking for are these effective dates. And so you’ll have these in the platform for those ones that are… active and who’s part with who I talked about those different locations as well. So you have all the locations associated and we can, you know, sort and other things like that. Just like any other spreadsheet or you can see, you know, who is my most recent person that is effective with the payers. So I kind of know that or I can filter by all of these different items here to really, I mean I can really get to whatever level of detail I need around these enrollments just from the platform. And if you want to be, if you want to get this out of the system, it’s as simple as just downloading this as a CSV, you can mess with it on your own with, you know, Google sheets or excel, which is super easy. But again, most of the time organizations are just using, the platform here because it’s pretty similar to a spreadsheet. And then from a report perspective, if there are things like I want a location report or I want a provider report, whatever it might be during implementation, we can create a lot of these reports for you. So they’ll just be scheduled in a cadence where members of the organization who need to get this information, we can send it out regularly to them. So the example of like let’s say it’s like a report by location or whatever it might be. We can have those available for you day one. But just zooming out the visibility that I’m showing here for organizations can sometimes be difficult for a variety of reasons one, it’s you have to manually update it. That’s the biggest problem here. Like this data that you’re seeing doesn’t really matter because it’s manual, is it updated? And that trust is a big component. So with this, all of the you’re seeing here due to our automations is things that your organization can trust. Like this is the updated information it’s coming from payers and it extends to the other parts of operation as well. This is like the ncqa credentialing, you also have all of that visibility around that out of the box as well. So kind of thinking about what your executives are looking for and kind of Doris what your vision for reporting is. This seems like it’s an upgrade from the current state. But I guess my biggest question is like what’s what are you not seeing here that you think would be valuable from a reporting standpoint? You know, things.

DORIS G PRINCE (75:42) Today that we’re tracking and it may have been there and I missed it, but I know like turnaround times definitely is key. But also when I say turnaround times, turnaround time from, or time I should say to track, when did we get the new provider alert versus what their start date is? That’s that’s key for us? Because then if it’s a short turnaround time, we didn’t stand a chance, you know what I’m saying? There’s no way that we could have met that deadline but yet we’re held accountable to it. So that’s some of the things that, you know, especially in this time of physician shortage that we have today. It’s more hurry up and start. We’ll worry about the loss later because we know down the road we’ll be okay, but they forget that three months after the physician started, then they’re knocking on my door and Kristen’s door going okay. We’ve lost 300,000 dollars. Why we’re like don’t forget you knew that going into it because we had a short turnaround time. But then we just have to remind everyone of that. So turnaround times is pretty key. One of the things that we track today is the type of provider or type of new provider requests that we’re receiving? Is it a new provider? Is it a change? So we can have a provider that may work for SMG today. But since we have a shortage over at rockingham, they’re now going to have to move that provider over there. That’s key for us because each one of those contracts and how the ownership of those medical groups work, we have to have a new provider agreement. You know what I’m saying? We have to have an actual signed document in order for those clinicians to move around. So it’s like a checkbox for us to make sure that we know what type of request it is, so that we can check the box and make sure that everybody did all their pieces they were supposed to do. So that we don’t get bit down the road somewhere… trying to think of other things I know for the reporting out that Kristen has to do on a regular basis, like to leadership and everything. It’s more around those new clinicians about those new requests, those cross creds or changes that are happening because they wanted the status of them, their existing providers already know.

DORIS G PRINCE (77:52) Yes, they’re enrolled. If I’ve got someone new or someone that we’re changing things with what is the status of them? But yes, definitely want to know the volume, how many we haven’t come in that we see it by month, they like to see it by the year, they like to see the volume. So we can track and trend, you know, when are our biggest spike months. So we can also plan for that. We typically know what it is just because we’ve lived through it so much now, new grad season typically is our biggest, but I can’t say that’s the truth because goodness, lord knows we did some expansion of some of our specialties and the holiday season was horrible because we had a couple of 100 providers that we had to hurry up and push through like in two months. So again it just depends on the flow of what’s going on within the system.

Garrison Goodman (78:38) Doris, during those spike periods, are you and the team just growing a third and fourth limb or are you bringing contractors on the team or how do you manage those? We’ve.

DORIS G PRINCE (78:48) currently, we’ve been managing it via overtime and just pulling sources within our own team to help do what we need to get done. We push up our sleeves and help as well as you may pull payer enrollment in to do something else. You may pull others in to help pay or whatever it may be. In this instance, we were lucky enough that we didn’t have to do payer enrollment because it was our anesthesia group which is 100 percent outsourced for billing and credentialing, but we had to own boredom because since they already had, they had to have hospital privileges. And that’s what we talked about before we are very connected to the hospital. And those are all the pieces that if we were to go down this path, we’re going to have to really figure all of that out because again we are very joined at the hip. We spent three years doing that… in order to try to make a more streamlined workflow process and all of that. So that our providers when they were joining sentara, didn’t have a medical group application, a hospital application, and then an ms, you know what I’m saying? All those various and then make sure that we all were asking the information consistently versus with variation the same information. But I asked it this way, the hospital asked it this way and then someone else and then recruitment or someone else asked it a different way just trying to make sure that we were consistent in how we’re gathering information and hopefully only asking for it once as we move forward… trying to think what else? Go ahead. Yeah, I.

Garrison Goodman (80:17) was going to say that’s helpful. And I don’t know if it’s worth opening up the can of worms on this call, but if it is, but you mentioned how tightly it’s going to have to work with like the hospital’s teams. Anything that you have seen or haven’t seen that would make some of those conversations go internally. And when those folks have to weigh in on the systems for your operations… you mentioned some other operational leaders and the reports and visibility they’re asking for. Can you maybe help us understand who all has to be involved and the things that we’ll need to address for those?

DORIS G PRINCE (80:56) Folks, yeah, I think, I mean as far as the operationally and reporting out to others, I mean, as far as Kristen’s monthly reporting and that kind of stuff, it’s pretty much us. And then we’ll have to again, we’re going to have to change how we’re doing things today anyway. Because again, I think what we’re going to end up having to do from an operational standpoint with our practice operational leaders, these are the reports that are available things that we can give you. And this is how we can give them to you. We’re going to have to go down that path so that we can start streamlining things because today, we pretty cater to everybody and we want to change that, you know what I’m saying? We don’t want to have this type of report for one leader, this type of report for another leader, this type of report for another. Let’s try to streamline those things. So it’s consistently across the system as reporting things out from that perspective. Now, as far as what we’re going to do is about talking with the hospital and the medical group, because we’re all in the same system. I know Casey was looking to come into Healthstream as well. We’re going to have to talk about that and get with those leaders. We actually have a work group currently that’s meeting to say all things credentialing. Is it right? You know, what is the current state? What should the future state look like? And we actually have one of those meetings tomorrow. Kristen and I do with other leaders, senior leadership and our hospital counterparts. So again, we’re having those very candid conversations because again, for payer enrollment, we understood there was a sentara initiative to have a singular system singular application. And we went there and that’s where we’re at not saying it can’t work. It’s just very manual and very voluminous for us is what I’ll call it. So does it make sense to keep Healthstream maybe, but for us, it may not make sense if that makes sense? Yeah. So we’re going to just have to have those very candid conversations what is best for each team and each unit? And for sentara as a whole? Yeah, how.

Garrison Goodman (82:55) can we best support you as you start those conversations? My follow up question is what’s the best way to help you complete this evaluation? We’ve got a tried and true process, but it sounds like.

DORIS G PRINCE (83:06) right, right. I think now we have to let the others know. I haven’t even shared with the other teams yet that we’re doing this because again, Melinda had reached out to Ron and I to say, hey check this out. That’s the reason I reached out to you. Kyle. I think it was to say, hey, Melinda asked me to reach out and connect with you all to look at the software solution and see if it was a solution. And again, you know, then Bryce, who reports to Melinda, who we report up to? He said I want you to leverage AI technology. And that was what I saw when I perused your website was that this was very heavily AI, you know, centric. So I thought, okay, well, let’s look at it and see what we can do. Is it a compliment or is it a replacement? What is it? So, I think you kind of answered that today, this would actually be a replacement of Healthstream for us versus a supplement to it, correct? Isn’t that what I saw in the chat with Casey?

Garrison Goodman (84:02) Yeah, I think so. Casey.

Noah Laack-Veeder (84:04) Your question, I mean, we have most organizations who use credstream prior to medallion. They do decide to just replace it with medallion. So you have that like single source of truth. But ultimately, Casey, I think that’s a decision for us to collaborate on. I think we can talk through like and to your point, Doris around the privileging point. And there’s another team. I think that’s that would dictate whether or not that makes the most sense. But we do have an appointments module and privileging, we can do all that work too. So it’s right? So if the ultimate goal is to look like we want a single platform to do all that. I think it is worth investigating that. But Doris, I kind of want to take your lead there. And what you think makes the most sense?

Garrison Goodman (84:52) Okay. Yeah, I’m going.

DORIS G PRINCE (84:54) To follow back up with Ron and others. And then we’ll definitely circle back to you all because again, I’m I know, you know, Casey, you can help me with this. But the one sentara initiative, one of the things that sentara is really big on is trying not to have five different applications to do the same service, you know, because then it makes more sense for us to be able to leverage a singular system if at all possible. And especially in this case, because it is our provider data, you know, sentara is really looking for a single source of truth for all of our clinician data somewhere, whether that be our community providers that, you know, render care in our hospitals and we partner with them. They have privileges in our hospitals, whether it be our payer department. And I say our payer, our health plan, sorry, because our health plan is on credentialstream as well. Sentara health plan is, so we were the last to come into the credentialstream world because we were looking again to get away from the excel spreadsheets and everything being outsourced, but be able to have it more so internally to have better control because the vendor we had was okay, but they weren’t the best. So we were looking to bring it back in house, yeah.

Garrison Goodman (86:06) So, Norris, I think there’s a couple of things there. One is like, hey, we have quite a few teams using credsteam today. There’s a perspective. Hey, we like the idea of having less vendors. Secondly like there’s also, hey, where can we leverage automation and AI to consolidate a lot of what we’re doing manually and scale through technology rather than spikes of adding people and down periods. And then third is really understanding what are the other operational leaders want? And then what are the phases of approaching this?

DORIS G PRINCE (86:38) Like Noah?

Garrison Goodman (86:39) Mentioned, we have customers who use this across privileging and not, we have some of the teams that are separated where privileging does their own thing and cred and PE does their own thing?

DORIS G PRINCE (86:48) Our answer?

Garrison Goodman (86:49) Is typically, yes, it’s just what is the flavor that you want? And what is the best way to approach this? Now, second third year, we can do this in phases as well.

DORIS G PRINCE (86:59) Typically.

Garrison Goodman (87:00) What our customers will do from here is, hey, we’ll map out what you’re doing today. We’ll map out what a future state looks like. We’ll validate the business case in twofold which is, hey, your finance team’s flag. We don’t want to grow our opex this much as we scale, but also where’s the time savings come from?

DORIS G PRINCE (87:20) Correct. And then,

Garrison Goodman (87:21) the other thing we like to look at too is what our current turnaround times for your payers, there’s typically a big gain there. We talked about that last, we’re not sure where the numbers add up. We’ll refine that, right? So that answers the question of, hey, why would we bring in a new vendor here’s? The.

DORIS G PRINCE (87:36) business?

Garrison Goodman (87:36) Case for that as to how horizontal this goes. There’s some questions on that. So that’s what we typically go. It sounds like you’re starting those conversations internally, Doris, what’s the best, you know, approach that you think? And how we should align to working with your team. And when we should start next steps. Okay. Well, we have.

DORIS G PRINCE (87:55) A big meeting tomorrow. Like I said, we have a meeting tomorrow with several of our executives. And one of the biggest initiatives that we have currently is physicians again bringing them on clinicians, whether it be a physician, nurse practitioner, whoever who the provider may be. There is a huge, I mean, they have a I’m going to call it. We used to call it the war room. Now it’s called the win room. Let’s all get in a room and see what we can do to win. So there’s a huge initiative around as a system. How can we move things along faster? How can we get that clinician onboarded sooner than later all the way through from recruitment from hiring new talent acquisition, then to credentialing privileging and all of that. So we’ll all be in a room tomorrow after I think it’s tomorrow. Is it tomorrow or Wednesday? So my thought is we would bring that up then and start having that conversation with them, and then we can circle back with you guys.

Garrison Goodman (88:57) Okay. What would be most impactful for you in that presentation that we could help you prepare? I think the.

DORIS G PRINCE (89:07) Biggest thing is being able to show how quickly you’re able to turn things around, you know, what I’m saying? And then like for your caqh and all those other pieces. And then, you know, again, I know it’s all going to come down to pricing, what is that price tag and things going to look like as well. So again, it’s a matter of, I think right now the biggest thing is being able to share and let everybody know that, yes, there is the advantage of the caqh bi directional that’s going to save a huge amount of time because right now you have to do caqh before you can even start pay or enrollment. So if we’ve got a three day delay or a four day, you know, lag there, but it’s something you all can do in a day. We’ve already gained time there. Does that make sense? And then the same thing with the payor enrollments, if you can get it out the door and process faster than what we’re able to do it, then that’s a gain there as well. And then trying to think of what else the primary source verification was. One of the biggest reasons we brought this back in house with Healthstream is because our prior vendor was taking a significant amount of time and I think now, Nicole, I think the last time you checked if you were to average it out, we’re like at 15 days now for total turnaround for our primary source verification. I think it’s like 15, something like that.

Garrison Goodman (90:26) But all.

DORIS G PRINCE (90:26) those little pieces, they add up to a lot that helps us to bring those clinicians sooner faster and also get them enrolled quicker. And that’s the other thing sometimes especially with nurse practitioners and those you can hire them because they’re I don’t want to say staff level employees, but they’re hired like staff. Yes, we have the primary source but they can bring them in and they can work as a nurse until we get them pay or enrolled. But if you can get them pay or enrolled a month ahead of time. And if they’re already here, they can now start practicing medicine. You know what I’m saying being a nurse practitioner versus an RN, those type of things. So I think those are some of the things that, you know, we’re trying to figure out how do we do, can we do? What can we do faster or better that’ll help as well? Okay. Well.

Garrison Goodman (91:13) What, you know, there’s obviously a lot to do before tomorrow. I don’t know if we’ll get how much we’ll get done, but we will, I’d like to follow up with like just high level questions of what we talked about. Hey, how many people providers that you intend to hire? What are the payers that you work with? Or maybe like your top five, 10, majority of where you do business, your turnaround times for those. If you have, you know, directional accuracy on that, we’ll go to our analytics team and tell you what ours are and.

DORIS G PRINCE (91:44) Then we’ll.

Garrison Goodman (91:45) also kind of refine, you know, kind of what Kyle had led with originally around, hey, here’s where a business case could be from an opex savings perspective, like in, you know, future years as well. And so, you know, we’ll get that. So it’s like conversationally ready where it’s like, hey, we obviously have to refine this and get.

Noah Laack-Veeder (92:06) More accurate but directionally.

DORIS G PRINCE (92:08) You know, we,

Garrison Goodman (92:09) can we can put something together that hopefully is, you would feel comfortable with, hey, if we solve this here’s, what it would accomplish for the organization?

DORIS G PRINCE (92:17) You had.

Garrison Goodman (92:19) asked a question around like, hey, how fast can you do this? You know, Noah, keep me honest here, but I would say for new providers, given the setup that you detailed, it could be two to four weeks to… that for all new providers that you’re onboarding, you could start credentialing them, rolling them with medallion. And then there’d be another probably four to eight weeks of transferring your existing provider data over. And that’s like not a full time job that’s a few hours per week. It’s just making sure that we can transfer the data over so that you have a single source of truth for all your providers.

Noah Laack-Veeder (92:58) Just to jump in really quick, Doris is like that’s not the timeline we think it would take to get them credentialed. It’s just like that’s how long it would take for us to like be able to do that right? Set up?

DORIS G PRINCE (93:11) And start, yeah.

Noah Laack-Veeder (93:12) Yeah. And so we can move really quick and I mean, how long did it take for you all to get up and running with credstream? Well, that’s a.

DORIS G PRINCE (93:21) Loaded question. And the reason being because we, it was us and the hospital at the same time. So again, it was making sure all their, they also revamped all their dops and you know what I’m saying? So that, it was a lot sure.

Noah Laack-Veeder (93:38) So from.

DORIS G PRINCE (93:38) us, I mean, again, we really from my privilege, I’m sorry, from my payer enrollment standpoint, we really didn’t start digging deep into that until what may or June. And then we had an October go live. So again, you know, data conversions and everything. So again, it’s our biggest thing was we’re living in the same instance as our hospital who used it very differently. And now we had to totally change. A good example is that you may have a license number field. I use this all the time, a license number field. They were typing words into it because they didn’t want the license number, they wanted the verbiage to display. So if it was family medicine, they wanted to say family medicine, they didn’t want the family medicine licensure, we had to have the licensure in order for it to flow on our applications. Yep. So, you know what I’m saying? So we had to take that time to go well, you’re using that data field for this, but we need it for that type thing. So, that was a lot of the pain that we had to go through and some of the things that took so long.

Noah Laack-Veeder (94:41) Yeah, but I think to garrison’s point, like I think it’s worth us investigating what path makes the most sense to get you the most value first. Oh, agreed. So it’s so I think like there’s a world where we just help you with just payer enrollment and just kind of have some sort of integration with your system to make that work. There’s a world where we replace everything. I think obviously, the more we want to boil, the more conversations we have to have which we’re totally willing to do. And I think that’s maybe a good option for us to come on site, right? And talk to that kind of stuff, right? But I, yeah, and so kind of in your mind kind of initially we, I think I asked this question maybe two calls ago, like you had an interest of kind of starting with just the payer enrollment function and seeing how that, is that still kind of where your mind is at? I?

DORIS G PRINCE (95:32) Have a feeling that’s where we’re going to have to go because again, the hospital was on and Chris, you have to correct me on Healthstream which became Healthstream for how many years, probably the last 15, 20 years? I mean forever and ever, it’s 17 years either ms. Sentara. So there you go, right? So it is a software solution that they have had forever. And now our health plan is embedded in it as well. So, I really think, you know what Ron and I were asked to try to solve for was payer enrollment because again, we just brought it in house and we can see that the strain it’s going to cause and the delays it’s going to cause with the software solution that we have. If that makes sense. Either that or we’re going to have to very muchly that’s not good even language there. We’re very much going to have to add a ton of staff to get us where we need to be.

Noah Laack-Veeder (96:30) Yeah, I think one.

DORIS G PRINCE (96:31) Or the other, yeah, that.

Noah Laack-Veeder (96:33) Big thing is like we think about PE payer enrollment. We think about the ncqa cred, we think about the internal credentialing, right? There is growth that is happening. And it sounds like, I mean there might be challenges across the board. But like the one challenge that we’re trying to solve for right now is how are we going to do payer enrollment with all of this growth? And?

Garrison Goodman (96:52) From what.

Noah Laack-Veeder (96:53) you’ve seen today, I don’t want to speak for you but it seems like medallion could be the solution for that. And then I think the pieces investigating, does it make sense to expand? But from your standpoint… immediate priority is just like the PE opportunity, correct scaling. And one thing we can do is like if well we can send because I think we definitely want to, we want to provide you with that turnaround time analysis. So I can have my analytics team, you know, do that for us. We just need to get a couple okay piece of information from you.

Noah Laack-Veeder (97:32) But also, I think one thing that and garrison and Kyle feel free to jump in here. Like one thing we do help organizations figure out is like what do we see the fte requirement being with this scale? So we can kind of tell you what we see in the industry, and then talk about what we think the resource allocation would need to be with the medallion given that scale? Okay? So if those sound like good next steps to you, we can send you a couple questions via email.

DORIS G PRINCE (97:58) Okay. Yep, send them to me and I’ll shoot right back out to you. That way you can have that.

Garrison Goodman (98:02) What time is your meeting tomorrow it?

DORIS G PRINCE (98:05) Is at four? Okay. Four o’clock tomorrow. So at least we have all day.

Garrison Goodman (98:09) Yeah, I was going to say, would you have time tomorrow morning to have us run through what we’ve put together for you? Okay. Yeah, just.

DORIS G PRINCE (98:17) Let me know what time and I’ll make it work. Okay?

Garrison Goodman (98:21) Kyle, Noah, do you guys want to look real quick? What would work? Yeah… I think I’m fairly open in the morning.

Noah Laack-Veeder (98:30) Yeah, my calendar’s up to date. So, yeah, I can.

DORIS G PRINCE (98:33) jump on anytime. I think the only thing that I really have to get on is a Pecos audit thing, which is like at 12 30 before that I can either delegate or someone else is already on the other calls up until that point. Okay?

Garrison Goodman (98:46) Noah, Kyle, looks like Noah, you’ve got a couple of internal things. Could we do nine a. M. What?

Noah Laack-Veeder (98:53) Day again tomorrow? So eight a. M, our time, Noah? Yeah.

Garrison Goodman (99:01) Oops. Sorry about that. Yeah, nine eastern. Okay. Well, good deal. Well, thank you all for spending all this time with us. Thank you. I feel like we’ve learned a lot about your business and, but we’re excited. I mean, when everything we’re hearing, you know, Noah and Kyle and I were messaging back like, hey, this is exactly like what medallion does and what we solve for. And obviously, we have to empower you all to have those conversations and make sure the right people are on board with diving deeper, but we’re really encouraged and you all are great to work with. And so we hope this goes well tomorrow and we hope we can help prepare you and we’ll talk then all.

DORIS G PRINCE (99:38) Right. Sounds great. Thank you so much. I’ll look for your questions and get that back to you. Yeah. All right. Thanks guys. Appreciate it. Have a great one. Take care. Bye bye.