Transcript
Jordan Tantleff (00:00) good morning. Sorry. What’s your name? It’s just seeing a shoot.
Sschutt (00:12) Yes, my name is Stephanie. I am the.
Sschutt (00:19) I’m drawing a blank. I’m the follow up manager here at gastro care partners. So, I have the insurance follow up as well as a self pay follow up.
Jordan Tantleff (00:31) Got it. Awesome. It’s nice to meet you. Are we… waiting on Victoria here as well or anyone else?
Sschutt (00:41) Yeah, I assume Victoria long term?
Jordan Tantleff (00:43) Okay, perfect. Where are you based out of Stephanie?
Sschutt (00:54) I am in Michigan? Okay?
Jordan Tantleff (00:58) You guys getting the warm weather yet, or is it?
Sschutt (01:02) Goes back and forth. We’re supposed to have some snow today, but yesterday, it was 75, so.
Jordan Tantleff (01:08) Make that make sense? I’m in New Jersey. So also kind of, you know, bipolar weather, but today, it’s finally 75 and sunny. So good to enjoy some fresh air as opposed to being stowed away in the apartment.
Sschutt (01:27) Yes, the last two days, we’ve gone on walks. It’s been really nice out but it’s supposed to be rainy for like the next, I don’t know week it feels like, but we just got home from vacation. We were in Georgia where it was 85 and sunny.
Jordan Tantleff (01:43) Very nice. Yeah, there’s nothing worse than when it’s just not consistently one time. I feel like my entire closet is still in play at any point when.
Sschutt (01:56) it’s back like this?
Jordan Tantleff (01:57) Yes, and.
Sschutt (01:58) I have a young one who’s nine and he’s like, can I wear shorts? It was hot yesterday? Can I wear shorts? No, no. It’s going to snow today. I feel.
Jordan Tantleff (02:09) Like at that age in shorts, you can still go out in the snow. Like you don’t feel anything at that age? Running around? Ah, yeah. It’s.
Sschutt (02:19) spring day at school today, I was very upset that I made him wear spring colors instead of spring clothes.
Sschutt (02:31) That means to wear a turtleneck?
Jordan Tantleff (02:34) Yep. No rush.
Sschutt (02:41) Did she send it to anybody else? I only saw?
Jordan Tantleff (02:47) Victoria on the invite? I didn’t see any other kind of accepted inboxes here.
Sschutt (02:55) Well, and I don’t think our accepted goes through, which is okay. She does have the voting manager also. Okay. But I don’t know if she’ll join. V, just said she’s running late for another call. I know you just have a quick 15 minutes.
Jordan Tantleff (03:19) Yeah, no worries. Victoria’s popping in here now and we can go a little bit over. I’m not sure if you guys have like a hard stop.
Sschutt (03:28) I do not. Perfect.
Jordan Tantleff (03:33) Good morning, Victoria. How are you doing today?
Victoria Ellison (03:37) Hey, Jordan. Good. How are you?
Jordan Tantleff (03:39) I’m doing well. Can’t complain?
Victoria Ellison (03:42) Apologies for the delay there. Thanks for this time I was doing, you know, some quick research payor enrollment tends to be just our achilles tendon right now. Just keeping up with it.
Sschutt (03:55) In.
Victoria Ellison (03:55) My research and I think maybe you or somebody hit me up on LinkedIn. I can’t remember. But anyways, that landed us where we’re at today and I know we only have 15 minutes or so as an intro. I just wanted to learn more about what the product is and what it’s not as we’re starting to explore options.
Jordan Tantleff (04:15) Makes total sense. And yeah, it was me and my colleague. I know Michael had been reaching out as well. So happy we’re able to sync here and I don’t have a hard stop, you know, after the 10 minutes here. So if we need to go a little bit over, we certainly can.
Victoria Ellison (04:30) But,
Jordan Tantleff (04:31) just to introduce myself, you know, Jordan tantliff, I’m one of the account executives here at medallion, been here coming up on three years at this point.
Jordan Tantleff (04:39) So I’ll kind of be the point person as we as you guys, you know, evaluate medallion, decide if there’s a mutual fit for a partnership and kind of, you know, align on next steps and what that may look like kind of before I jump into anything about medallion would love to kind of understand how you’re thinking about or how you guys are currently working from provider onboarding, you know, enrollment, credentialing and privileging, I think also came up as well. I know my colleague, Michael spoke with the director of cred. I believe you guys were using credentialstream today, if I’m not mistaken. So I’d love to get an understanding of kind of what that process looks like and, you know, maybe what gaps you might be looking to fill that credentialstream might not be addressing for you all today, and we can take it from there.
Victoria Ellison (05:25) Yeah. So we have Healthstream. And just in January, I made a valid effort to load all our providers in there with the idea, I mean it’s just like a data housing system to utilize for triggers to proactively manage, you know, expirables revalidations, anything that it would allow us to. I, admittingly and staff have not worked in that system. That’s just kind of high level what we were intending to use it for. As, and I’m sorry, I know I didn’t do intros. Stephanie oversees our Ar and is intricately involved with credentialing denials and challenges that we’re having from the payer side. And then I oversee the revenue cycle for GCP. Both of us joined about nine months ago. So I should have left with that. So as we’re working through what is credentialing enrollment look like we’ve historically had one person overseeing both. And I’m trying to separate, is it a lack of resources? Is it a lack of process? Is it a lack of systems? How many ftes are truly needed to be able to manage both areas? And so doing so, the payer enrollment piece just seems to be an area in my opinion that if we can have a system workforce, it just expedites the workflow a lot more. And it gives Stephanie more visibility when she’s appealing and things like that. I don’t think that Healthstream is a robust system. I don’t think it was ever intended to be at least at this point when I spoke with them. And so it’s just like a data entry keeping place right now.
Jordan Tantleff (07:04) Absolutely. Thank you for the context. I’ve been having a lot of conversations specifically with PE backed msos, similar business model to gastro. And this same type of conversation keeps coming up where there’s a system in place that’s more of an organizational tool as opposed to like an end to end kind of vendor or partner. And that’s kind of the main difference I would say in what medallion has to offer versus some of those types of self service type softwares. So at a high level, you know, medallion automates, I’m not sure if you guys take on any kind of licensing work for your providers or not we automate the entire provider lifecycle.
Jordan Tantleff (07:48) So we automate state licensing credentialing, so like the PSV work as well as payer enrollment with SLA backed turnaround times. So we typically see when we have these conversations that the enrollment kind of turnaround times are anywhere from 90 to 120 days. With medallion, we’re averaging around 50 days. So tightening up that turnaround time window while allowing organizations to operate exactly what you just mentioned that roughly, you know, one credentialing or one full time employee for every 1,000 providers or so versus, you know, software where software is in place. It’s usually one full time employee for about, you know, 100 providers, 200 providers, whatever that may be.
Jordan Tantleff (08:33) So when you think about medallion, there’s really three kind of main value drivers that organizations would kind of decide to partner with medallion on one being, you know, the revenue acceleration piece where medallion kind of helps eliminate claim denials, and prevent write offs while accelerating par approval to enhance cash flow. And then the kind of reduced opex or, you know, future opex side component. Is this as well? Where medallion, it sounds like you guys have one full time employee today. So the whole point of partnering with medallion would be automating workflows and allowing that full time employee to work effectively within our system to scale without adding additional headcount, if that makes sense.
Victoria Ellison (09:14) It does, okay, that’s helpful. And that’s the precise model we have right now basically one fte we’ve got, I don’t know ad providers and it just feels like we can’t keep up so that’s intriguing from a payer enrollment into now. I guess we would need to set up a demo to understand how that works. Okay?
Jordan Tantleff (09:37) Yeah, we can. So I think a helpful next step and we can kind of discuss more as well here, but certainly would like you guys to see the platform look and feel what it would look like within the platform. There’s a provider login view that we would go through. So like what the provider would actually see when they go into the medallion platform and then the admin side of it as well, where that one full time employee would be spending most of the day to day operations on. I’m curious if the so like has enrollment, is… it like turnaround time specifically or is it more of the claim denials piece? And is this something that’s like being, you know, brought down from senior leadership as well? Just given like the ties to revenue acceleration and even EBITDA for a PE backed org like yourself?
Victoria Ellison (10:24) Yeah. So a few things we have, I think it’s just if I had to assess the situation, it’s a lack of prioritization and organization. And in doing so, we have three markets. And so when we have different revalidations and things coming up, she’s also challenged with onboarding, the new providers. When you mentioned the providers logging in, we are basically a white glove service and we do as much as possible for our providers. Why would a provider need to log into medallion?
Jordan Tantleff (11:00) Sometimes they would like to go in and kind of see where they are in the enrollment process. That’s something that’s totally up to the relationship that you want to have with medallion. It doesn’t a lot of organizations we work with providers don’t log into medallion, but it’s just an option if they wanted kind of visibility. We kind of take on a lot of the onboarding part in itself because we have a direct integration with caqh so that’ll pull roughly 80 percent of the data we need from the provider upfront to start kicking off those workflows. And then that’s this is where normally a provider might log in depending on how you know, an organization or client we partner with wants to operate, either the provider could come into the platform and kind of fill in any gaps of that provider data or it sounds like this is something that the full time employee at GCP would do, they can log in as the admin and kind of plug in the provider data from there to just fill in the gaps to kick off those workflows.
Victoria Ellison (11:54) Okay. Yeah. I think I would need to see a demo. But while I have Stephanie on the phone as it relates to the peer enrollment denials, can you just speak a little bit more of any success stories you’ve had in that area?
Jordan Tantleff (12:06) Yeah. So we actually partnered with family care center, which is a behavioral health organization at the time when they came to us.
Jordan Tantleff (12:16) They had, you know, five clinics and about 120 providers with two people doing credentialing and enrollment in house. Since partnering with medallion, you know, over the last three years, they’ve been in client for three years. They’ve grown to now 45 clinics and 650 providers. With that growth. They’ve still maintained those two in house full time employees without having to add additional headcount at the time. They were seeing that 90 to 120 day turnaround times, we were able to cut that in half to 45 to 60 days. And they actually pursued, I’m not sure if you guys have delegated agreements in place or are familiar with delegated agreements. I can kind of discuss that as well. We were able to secure seven delegated agreements for them within the first six months. And the advantage of doing that is once you have a delegated agreement in place, we can shorten the turnaround time, we can turn out a cred file on average in zero point eight days and we contract to three day turnaround times on that… for.
Victoria Ellison (13:16) Delegated agreements. Is that just directly with the payer, allowing for a more fluid process?
Jordan Tantleff (13:22) Correct. So that you would enter into that agreement. And rather than sending out the enrollment applications to the payer, they would delegate the credentialing side to you. So.
Victoria Ellison (13:33) We take control of it.
Jordan Tantleff (13:34) Correct. And medani is an ncqa certified cvo so we can do the credentialing on your behalf. Yep. I’d be curious as you guys are rolling up new practices or new partnerships. Are you keeping them on their original tax ids or is it a strategy to kind of consolidate those based on the market you guys are entering?
Victoria Ellison (13:56) Yeah. So all of our contracts right now are non delegated and we work off of essentially three different tax ids and we bill under each provider’s nci. Okay. So I do think we have an opportunity to streamline that. But when I was delving in a little bit more because my previous life, our JV supported all of the credentialing enrollment. So it was a bit more efficient. But then that licensing and audit piece came into play where it put the onus back on the provider. So that’s helpful to know that you guys have those certs to back that up. This has got my attention. Let me ask you. I know we can’t go deep into pricing, but in general, how does pricing work for medallion?
Jordan Tantleff (14:40) Yeah. So we typically would forecast out what kind of use case and what kind of services we might be using year to year. So, for example, like we would try and scope out what your provider growth might look like over the next 12 months, you know, 24 months, 36 months, whatever that may be. And then based on that, you know, like do you guys know on average how many health plans or payers each provider gets enrolled with?
Victoria Ellison (15:07) I’d say about 15. Okay. Yeah.
Jordan Tantleff (15:10) So we would map out like the total amount of, you know, payer enrollment applications needed for that year and it’s per application. There’s a fee associated with that. And then we also do charge for each provider, a seat on the platform. So where we’re housing that data, doing ongoing monitoring services, if that’s needed from you all, and just making sure that we’re keeping them compliant and flagging any expirations coming up… I will say our deal floor is, you know, 50,000 dollars annually.
Victoria Ellison (15:43) Okay. I’d.
Jordan Tantleff (15:45) imagine given the current model that you guys have of a more of like a self serve software. Medine would be a premium just because we are end to end kind of handling the entire, you know, provider lifecycle and workflow. But that’s like directionally how we get the price and just like scoping out the volume of work that we’re doing and then pricing that out over the next, you know, 12 months, 24 months, whatever that may be.
Victoria Ellison (16:11) Okay. All right. That’s extremely helpful, Stephanie. I know I asked all these questions, anything while you’re on the call?
Sschutt (16:20) No, I guess just from like a payor… perspective, like and I’m going to use the example that we have right now like medicare pay cost wasn’t updated with a provider’s updated license. And so we’re getting a bunch of denials. And although it was flagged as, hey, this is up for renewal, it kind of got pushed to the side with new payors onboarding. So, how does medallion do that if you’re an end to end service and that new license comes up and needs to be sent out to places like paycoast? Does the system do that automatically or we have to trigger it? But it reduces the time needed because it’s got all the input. So.
Jordan Tantleff (17:07) We would have any kind of expirations like push notifications for 90, 60 days, 30 days out on a license that may be expiring. In this case. Medallion does handle kind of state licensing and renewals. So that’s a service that we can offer as well. A lot of clients we work with, don’t necessarily offer licensing as kind of an add on to being a part of their network. So we would be notifying the provider of that, you know, upcoming expiration, and if it’s their responsibility to handle it, you know, that might be the relationship, but medallion can certainly take that on as well. Did I understand the question there? Accurately? Okay.
Sschutt (17:47) Perfect. I think that’s all I’ve got for right now. Yeah.
Victoria Ellison (17:53) Yeah. And this was just kind of that intro call. And Jordan, I appreciate you hopping on so quickly what’s the best way to schedule a follow up that would go a bit more into the weeds with the demo etc?
Jordan Tantleff (18:04) Yeah. Do you guys have your calendar in front of you by any chance? I do pull this up here?
Jordan Tantleff (18:21) You guys are both Eastern Time, correct? Yes. Okay. Perfect. Do you guys have time on… April ninth? Anywhere from 10 a. M to 11 30 a M Eastern Time if?
Victoria Ellison (18:37) You don’t mind, could we look at the seventeenth or after? I’m just, I’m going to be trapped over the next two weeks, those two weeks.
Jordan Tantleff (18:50) I do want to bring in, I’ll loop in my solutions consultant as well. Who will go into the weeds? And the first availability I’m seeing with him out that far would be April thirtieth pretty much at any time. Is that okay?
Victoria Ellison (19:05) Yes, I’m actually fairly open with the exception of one to two.
Jordan Tantleff (19:12) Okay. Should we shoot for 10 a M Eastern Time? Yeah, on the thirtieth, and if we need to push this around as it comes up, no worries.
Victoria Ellison (19:20) Absolutely. Will you be sending over an invite?
Jordan Tantleff (19:21) I’m going to send over an invite. Now. I’ll include Stephanie. I don’t have your email… unless Victoria, if you want to just forward it around, we can do it that way as well. Yeah.
Victoria Ellison (19:32) It’s just her last name SSCHUTT at gastrocarepartners com.
Sschutt (19:39) Got it.
Victoria Ellison (19:41) Steph, if you’re feeling froggy and want to jump on it by all means?
Sschutt (19:45) No, I do. I.
Jordan Tantleff (19:47) Will send that out and then just to try to get an understanding of timing because it sounds like you guys just signed with Healthstream.
Victoria Ellison (19:56) We just renewed it in January, but it wasn’t yeah, it wasn’t something that would stop us from pursuing something else. I just had to get something in order.
Jordan Tantleff (20:07) Yeah, that makes total sense. I will send a follow up as well as the calendar invite here. Was there any other questions for today?
Victoria Ellison (20:16) No, this gave me the intro that I needed. I appreciate your time, okay?
Jordan Tantleff (20:19) Perfect. It was nice to meet you both and we’ll be in touch in a few weeks here.
Victoria Ellison (20:23) Sounds great. Thanks Jordan.
Sschutt (20:25) You as well. Enjoy your weather.
Jordan Tantleff (20:27) Thank you. Bye bye.
Sschutt (20:28) Bye.