Transcript
Peter Bosworth (00:00) hi Duane.
DeWayne Hiebert (00:02) Hey, Peter. How are you? I’m.
Peter Bosworth (00:05) well, thanks. I’m well, thanks a little busy with the end of the quarter, but all is well. How about you?
DeWayne Hiebert (00:11) It’s crazy busy.
Peter Bosworth (00:14) Yeah, I can imagine. Are you guys in what’s the busiest part? Dealing with all these clinics?
DeWayne Hiebert (00:23) Yeah, we have.
DeWayne Hiebert (00:26) I mean, we have a bunch of things… I think done about 12 contract amendments in the last two weeks. You know, everything has to be updated, all of our value based contracts, new quality measures, targets things like that for the current year. And yeah.
Peter Bosworth (00:50) Then.
DeWayne Hiebert (00:51) We’ve had some contractual disputes we’re dealing with and some fee schedule updates that the payers didn’t handle appropriately. So, we are dealing… with those trying to make sure we get paid, right? And then obviously, we have a lot of new practices joining us. Always a lot of new providers joining. So, you… know, that means a lot of credential activity. And then we’ve you know, one of the things that’s important for the medallion relationship and the platform is, you know, we’ve started the process of getting all 900 of our providers on the system. So, so far over the… last week and a half, we’ve invited. Well, we did let’s see at the end of last week, we did eight new, eight practices. I think about 60 providers and I just gave them the updated list of 10 more.
Peter Bosworth (02:08) With 10 more practices.
DeWayne Hiebert (02:10) 10 more practices with probably another. I didn’t count all the providers but 60 or 70 providers… and I’d actually like to… accelerate that… so… that’s important because we want you guys to start doing the credentialing right? So we can move to delegation.
DeWayne Hiebert (02:42) Yeah. And.
Peter Bosworth (02:46) that’s something we can, you know… that’s something where we can talk about the, in platform reporting and how providers are trending at like the turnaround times for them to complete their profile. Because right now and I’ll pull up on my other screen in a second, but it looks like average like you invited a bunch of providers. But then these providers haven’t necessarily accepted their invite and started doing anything. And that’s the process that you’re kicking off now more recently. And so once they joined… and accepted the invite, the average days for them to complete their profile is 13 days, and then that’s calendar days. And then, yeah, so that’s you know, certainly not uncommon for it to be around two weeks, although it can be much faster. Just really depends on the providers themselves. So.
DeWayne Hiebert (03:53) Yeah. And we’re trying to push. So, what we’re doing is, so each one of our practices, right? Has has a physician leader. So we’re sending an advance notice to the physician leader and the office manager saying we’re inviting all of your providers tomorrow… make sure they get this done. We’ve we’ve asked for them, to get it done within 10 days of when we send it out. Going… forward, I’d like to cut that back even and say, ask for five days, but we thought we’d start, with Penn and see how we did,
Peter Bosworth (04:38) Yeah. And so actually, as I look at this more… closely here, I’ll come back to this slide that I want to talk about, but come to advocare, analytics provider onboarding… this is where I’m grabbing this detail… but really quickly, so like this chart is charting out each month and this light blue one is what we care about. And so in March, which is like generally, when you’ve started to kind of like get this initiative going, it actually looks like it’s moving a lot faster than it was previously. So, average joined to profile completed is six days in March whereas it was taking two weeks before. So average joined means like we don’t want, we don’t care about this average invite sent to joined because we sent out all the invoices invites when we did the implementation. But now, like once they accept their invite to, once they’ve completed their profile is six days on average or on median in March.
DeWayne Hiebert (06:04) So, which… provider onboarding? Let me see here. Sorry.
Peter Bosworth (06:09) Provider onboarding?
DeWayne Hiebert (06:13) Okay. I just want to make sure I’m seeing the same thing now on my screen.
Peter Bosworth (06:19) Yup. And this… will just get better. Like, so the entire rest of the advocare provider network has now been told to log into medallion and complete their profile, no?
DeWayne Hiebert (06:33) Not the whole net. No, we’re doing it a slice… at a time just because we know we’re going to have a lot of questions, right? About the process and what do I do?
Peter Bosworth (06:52) That’s probably smart and.
DeWayne Hiebert (06:54) We know we don’t have the capacity to handle all those questions with the size of the staff that we have. So that’s why we’re kind of trying to do it over, you know, probably going to be a 10 week period. Okay? But, you know, I think what we would like to do and what I’ve talked to Jason about, and I know we need to complete the delegated agreement with you guys.
Peter Bosworth (07:19) But for.
DeWayne Hiebert (07:21) those that are then ready to be credentialed, right? We want to start credentialing them so that, you know, we can start with those who are ready. And then, you know, do them sort of month over month so that we… make progress on that front. Okay, which reminds me this is kind of a totally separate question but, you know, we tried to be very prescriptive with them.
DeWayne Hiebert (07:57) About, you know, we took screenshots of every screen in the profile. This is what you need to do, make sure you sign these, make sure you upload here, make sure you have no gaps in your employment history and in your, you know, so on. And we did the same for office managers.
DeWayne Hiebert (08:25) With, you know, the practice profiles because we want them to, you know, maintain their practice profiles, make sure that the hours of operation languages, all those things are correct because we do have a good opportunity here to actually have a book of record for those things which we don’t have currently. So that’s terrific. But the question that I had, is there an overall sort of instructional video overview of medallion? And I know there are various links… in some of the stuff for videos on certain topics. But is there a good like… overall video tutorial that I can direct people to?
Peter Bosworth (09:13) Yeah. What I would say to that is we have kind of tried to make the provider profile experience like much more obvious and streamlined. And so if you like, there was a little bit of room for just uncertainty in terms of profile requirements and past iterations of the profile. However we are hoping that some of these updates kind of assuage those concerns. So the idea being just like when you’re filling out anything, if you’re trying to buy something on Amazon and you don’t put the cvv code, it’ll turn red and say missing cvv code. It’s just like the same idea in medallion where we’re highlighting specifically what’s missing and calling out that it’s blocking work. And so really, when you’re doing credentialing, it’s intensive in terms of the amount of information we need. So the expectation is like we need pretty much every field, but we are calling out exactly what’s completely necessary. So if I like hijack this provider so that you can see exactly what dr Raman sees like it’s pretty, you… know, straightforward. But this… is what he would see.
DeWayne Hiebert (10:36) Okay. And.
Peter Bosworth (10:37) So, there’s always this option too, which like we do recommend if… they have caqh profiles. So you would put in the information and then it’ll populate everything from their caqh profile into their medallion profile… worth noting. Not sure if you saw this email that went out a few months ago, but caqh is there’s now like a pass through fee that happens when this is initiated this link? Okay? And so it… only the pass, the basically they are charging?
DeWayne Hiebert (11:18) A lot of money. I don’t remember the, what the, I don’t remember the email, what is the charge?
Peter Bosworth (11:27) It’s I… want to say it’s seven dollars. I’ll find the email and send it to you.
DeWayne Hiebert (11:36) Cause yeah, I think we’re doing that with everybody.
DeWayne Hiebert (11:43) Okay. So I mean, that’s not horrible. So 6,500 for our total network.
Peter Bosworth (11:53) Yeah, it’s seven dollars. It’s seven. It’s seven and some amount of sense seven 35.
Peter Bosworth (12:09) Medallion has a portion of the fee seven 35 per provider per year to applicable organizations, which reflects the amount charged if you created your own caqh account and incurred the caqh third data access fee from medallion.
DeWayne Hiebert (12:25) So, in.
Peter Bosworth (12:26) plain language, what happened is they started charging us a bunch more than they used to charge. And then we always just incurred that cost entirely wholesale. And now, because they’ve upped it in such a kind of like radical way, we’re just passing on the amount the exact amount that you would incur if you had your own caqh, like master profile to manage all your other providers.
DeWayne Hiebert (12:52) Okay. I’ll.
Peter Bosworth (12:54) forward you the email after we get up, get off though. Okay?
DeWayne Hiebert (12:56) All right. Okay. But there’s not like a necessarily a video tutorial that I could direct people to that kind of.
Peter Bosworth (13:07) I can probably what?
DeWayne Hiebert (13:10) We… what we’ve put together is probably just, I need to tell people look, you know, look at this. It’s comprehensive and it goes through each of the screens.
Peter Bosworth (13:26) Yeah. There’s also like the support articles and there’s a specific kind of provider onboarding section which I’ve just dropped into the zoom chat.
Peter Bosworth (13:47) So, there is like a, how do I complete my profile section?
DeWayne Hiebert (13:57) Yeah. Let me, I was looking in the support center before.
Peter Bosworth (15:15) We don’t have like a, you know, marketing approved video that walks you through how to complete your profile medallion with. But what I mean? I could record like a loom video, but it… wouldn’t be… you know, it wouldn’t be, I’m not sure if that’s something you want to share with like your entire provider network?
DeWayne Hiebert (15:42) Okay.
DeWayne Hiebert (15:48) All right. So, I have this, is there a similar section… like that for… practice profiles?
Peter Bosworth (16:02) For, so the providers themselves are not going to be filling out any of that group practice information that’ll fall on your like practice admins? Right? Yeah, that’s is that who you’re talking about? Yeah.
DeWayne Hiebert (16:16) I wanted to have something specific for them as well. Okay?
Peter Bosworth (16:37) Is it okay if there’s a, if it’s a support article?
DeWayne Hiebert (16:44) Sure. Yeah.
DeWayne Hiebert (16:54) So, there… is.
Peter Bosworth (17:07) Kind of just like a general group profiles… walk through?
DeWayne Hiebert (17:20) Here, which I will drop.
Peter Bosworth (17:27) But from the, I imagine your practice admins, like what you, you’re going to want them to come into practice location, add a new practice and then fill out the information for their specific practices plural?
DeWayne Hiebert (17:41) Yeah, no. And right there already there, right? I mean, what we really will need them to do is like, you know, you can pick any one, go into it. And… oh, that profile is actually pretty good, but any of them where their profile, right? Is not complete… we’ll… want them to, you know, get it above the 85 percent… understood. Yeah, there’s one that, yeah, like they don’t have any of their operational info in there, so.
DeWayne Hiebert (18:22) Okay.
Peter Bosworth (18:25) Got it.
DeWayne Hiebert (18:33) So, we actually have more that have decent profile percentages than I?
DeWayne Hiebert (18:42) Expected, but quite a lot that still have a lot of work.
Peter Bosworth (18:50) Yeah, I’m would it be helpful to have like a report of who’s below 85 percent?
DeWayne Hiebert (19:08) Yeah. Can you run that at the practice… level?
Peter Bosworth (19:23) Actually, okay. Let me see here. I, it’ll… be a little, I just need to do some, oh,
DeWayne Hiebert (19:34) well, we can just export that view, right? And then, yeah, and then sort it by completion percentage.
Peter Bosworth (19:40) That’s exactly, right. Yeah. Okay. It just comes out kind of, it comes out as a CSV, I always filter it to something different to like an excel. But yeah, you can download it right there. Okay. Okay. So, sorry, anything else you want to cover?
DeWayne Hiebert (20:06) No, I mean that’s really, I mean, I would say, right, we have, a couple of priorities with Jason, you know, right now, one is we, you know, we brought somebody back in temporarily to work on horizon because there were issues with that submission. Bethany, so, yeah, Bethany, so… I wanted her to kind of get caught… up with everything submitted for a June one effective date and before, and then, you know, work have her work with Jason and whoever on the team to kind of get them going on everybody after six one. So I… told Jason I was going to try and get that to happen later this week. So, I… may have to delay that a little bit because I was just, I just ran an updated report on all of those that are still on hold for horizon. And I’m trying to match that up to what she’s actually already submitted and not submitted because it may not all be updated yet in the platform. So, I think there may be a few that we need her to focus on this week and maybe.
DeWayne Hiebert (21:42) That will need to happen next week. But that’s one of the big priorities. And then like I said, the onboarding of everybody is the other big priority for us and being… able to actually have you guys start doing the credentialing, so we can start talking about delegation with the payers.
Peter Bosworth (22:04) Yeah, and certainly a big priority for us. And also something that… I’m personally looking forward to just because our ability to execute on that is, oh.
DeWayne Hiebert (22:16) Yeah, me too. I have no doubt that, you guys know how to credential them and that the payor enrollment piece, right? Is kind of a messy distraction, right? Having to do that is, and, you know, we’ll always have some of the payers right? And some of the smaller ones probably. And, but yeah, I mean, we, one of the reasons we decided to partner with you guys was for that piece because, you know, that’s our biggest priority is to be delegated with the major payers so that we can, you know, really impact the turnaround time.
DeWayne Hiebert (22:54) And, you know, because we have issues all the time, we have a complaint from one of our physicians who actually has from a revenue standpoint… the largest practice in avacare, like a 30 dollar a year practice. And he’s complaining that he had a provider start in January who’s still not credentialed and right? We always do. And you and I maybe talked about this, the gap analysis we do to determine whether they’re already credentialed with a payer or they’re gonna have to go through the full credentialing process. And so, right, we told him back in December, this provider would not be credentialed until April fifteenth at the earliest, but he still hired her January second even though we said this.
DeWayne Hiebert (23:52) And now he’s complaining that it’s not done right? Like well, you know, I don’t feel too sorry for you because we said it wasn’t gonna be done, but the, you know, the fact of the matter is right? He hired her because he didn’t want to lose her to a health system. Who could, you said we can employ, you know, by this date. But so the only way we can compete with that sort of turnaround time is to be delegated. So.
Peter Bosworth (24:21) Yeah. And that will be probably music to every one of your practice’s ears once that’s like up and running in a fluid motion.
DeWayne Hiebert (24:28) Oh, and it will be music most to my ears because if I can get out of this world of, you know, having to, you know, deal with the timing of this, you… know, that’s that is the biggest challenge.
Peter Bosworth (24:50) Yeah, is.
DeWayne Hiebert (24:52) You know, people don’t like the timeline when everything goes well, right? So, if there’s any hiccups along the way, right? It’s, a, it’s a real problem. So.
Peter Bosworth (25:04) Yeah, yeah. And, and yep… so like definitely… looking forward to seeing the profile completion come through. And then like all the credentialing requests come through. And then… yeah, the only other thing that was on my list today was like, I wanted to just quickly call out that we’ve and introduce like, our coo who has recently joined medallion, Nate Rosenthal, and he comes to us from airbnb, and before that square, and so just adding experience in the operations of medallion, somebody who’s worked with like scaled operations. And just like really taken, he was at airbnb for like seven or eight years. So really kind of was there as the growth was taking off. And so we’re really looking forward to and optimistic about how this, his leadership will kind of affect, our operations all the way down the board across all the different product lines and especially in payer enrollment first and foremost, in payer enrollment. So Nate, will I’m going to make sure that… you’re introduced to him as he’s trying to make an intentional push to meet with, our most, you know, strategic customers. So I’m going to make that happen in the next few weeks. Great. Awesome. And then the other kind of just smaller things was that, well, not smaller. I meant more operational. It’s just that our team, I know that you were just talking about Bethany and that whenever the time feels right, the ability for Bethany to meet with our operations team and discuss that horizon workflow would?
DeWayne Hiebert (26:51) Be great.
Peter Bosworth (26:54) And then the other thing was just the medicare demographic update kind of bottleneck issue is something that Jason is just working on every day to un, bottleneck those requests.
DeWayne Hiebert (27:11) And so.
Peter Bosworth (27:12) We are seeing progress on that internally.
DeWayne Hiebert (27:15) Yeah, I have seen, I have seen quite a few medicare approvals come through in the last couple of days, so.
Peter Bosworth (27:26) Yeah, it’s positive. Okay… excellent. That’s all from me. The next email will probably be just having Nate join one of these calls soon. And then also, I’ll resurface the caqh, seven dollar, 35 cent fee email that went out.
DeWayne Hiebert (27:49) Okay. All right. That sounds good. I think just so I know I asked you to move this call. So, I guess we’re meeting again next… Tuesday?
Peter Bosworth (28:05) Oh, are we? Okay. We can… oh, cause now it’s off the right. Well.
DeWayne Hiebert (28:12) I was going to say it’s probably okay. We could probably skip next Tuesday cause I don’t, the only thing update I would have which, you know, I can communicate with Jason about is like I said, I would, I had told him I was going to try and get time with Bethany for the team, you know, talk about horizon this week, but like I said, that may have to be next week, but we can make that happen next week. And then the following week… I am going to be out and so I am. And then.
Peter Bosworth (28:45) the following week, we’re scheduled to meet then.
DeWayne Hiebert (28:47) We’re scheduled on the 20 first, so, that should be fine for us to meet again then, so.
Peter Bosworth (28:52) Okay. I.
DeWayne Hiebert (28:53) ended up canceling all my pto over the holidays. So we’re scheduled to go somewhere. So I am not canceling on the thirteenth. Oh,
Peter Bosworth (29:02) good. I’m glad where are you going to? I’m excited to hear that.
DeWayne Hiebert (29:07) We’re going to go see some friends. We had some friends who moved out to California. We were neighbors for, I don’t know, 20 years. Nice. They moved to California. So they live in Malibu and… we haven’t seen them for a while. So we thought it’s a nice place to go visit them. So.
Peter Bosworth (29:30) Good. Yeah, I hope you get some RR and yeah, we’ll see you on the 20 first. So.
DeWayne Hiebert (29:38) Okay. All right. I appreciate you taking the time to meet with me and, you know, I think things are going in a positive direction. I think we got a lot of stuff to do but we’ve worked out some things and so that’s good. So… yeah, I told somebody, I see the light at the end of the tunnel. It’s kind of small, but it’s there.
Peter Bosworth (30:02) That was amazing. I.
DeWayne Hiebert (30:03) Said, you know, at the end of the day, we’re not going to get, we’re not going to get to where we want to be until we get everybody on and get everybody credentialed.
DeWayne Hiebert (30:12) So we can be delegated. And that’s like my, I’m a broken record with that, you know, because even from some of the providers, right? Who’ve gone through credentialing issues and adding, you know, providers to their practice for years, we’re like, well, why do we have to do this? I don’t want to fill out this profile. Why don’t you guys do it for us? And I’m like I can’t sign your attestation, you got to do it. You got to just, you know, take the time and do it. It’s the means to an end here. We’re never going to get to the end that you want. If you don’t put a little effort into it. So.
Peter Bosworth (30:46) I know, I mean, it’s so closely tied to getting paid. You’d think it would be a little bit more of a.
DeWayne Hiebert (30:51) Right. No, they like to say it’s your responsibility to get us paid, right? Right? It can’t be only the responsibility of a few of us. It has to be, everybody has to participate. So.
Peter Bosworth (31:08) Well, hopefully, one day it’ll all be automated from completely. So.
DeWayne Hiebert (31:12) We’ll see, I hope we’re talking in, you know, the fourth quarter and we have nothing to talk about except how you’re doing. So, I know we won’t be delegated by that point, but, you know, I hope everything else will be smooth… and we’ll be well on the way to that. So, yeah, I imagine, right? It’s gonna, it’s probably, I mean, what is a realistic timeframe do you think for you guys to credential 900 providers?
Peter Bosworth (31:45) Well, I mean, our, assuming we have absolutely everything on the provider profile, we’re turning around the credentialing files in like three business days. Okay? So we’re moving really fast in cred.
DeWayne Hiebert (32:03) That’s awesome. Yeah.
Peter Bosworth (32:06) Yeah. So that’s why we’re also excited about that so that it’s yeah, it’s more like it’s… just more automated like it’s just primary source verification. It’s just like, so it plays nicely into the way the current like tech stack that exists today, payr at the moment is a beast to automate. And it’s like our biggest… like continue to apply automation to these workflows that are like very difficult to automate because they’re just, they all have proprietary portals and they all like require some like two factor authorization. Sometimes it’s just like a nightmare. Oh.
DeWayne Hiebert (32:48) Yeah. And there, yeah. And… you know, they don’t communicate well, you know, if there is a problem, they don’t necessarily let you know. They just will, you know, cancel the enrollment or whatever, and it’s yeah, it’s frustrating.
Peter Bosworth (33:10) So, yeah, all.
DeWayne Hiebert (33:13) Right. Well, I am late for a four o’clock so I need to run, but thank you. All right. Take care. Talk to you soon.